Department of Emergency Medicine, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
Crit Care Med. 2019 Mar;47(3):e222-e226. doi: 10.1097/CCM.0000000000003632.
Manual ventilation of intubated patients is a common intervention. It requires skill as well as physical effort and is typically restricted to brief periods. Prolonged manual ventilation may be unavoidable in some scenarios, for example, extreme mass casualty incidents. The present study tested whether nurses are capable of appropriately manually ventilating patients for 6 hours.
Volunteers performed ventilation on an electronic simulator for 6 hours while their own cardiorespiratory variables and the quality of the delivered ventilation were measured and recorded. The volunteers scored their perceived level of effort on a standard Borg Scale.
Research laboratory at the Emergency Department, Tel Aviv Medical Center.
Ten nursing staff members of the Tel Aviv Sourasky Medical Center, 25-43 years old.
Volunteers ventilated manually a lung simulator for 6 hours.
The subjects' physiologic states, including blood pressure, heart rate, respiratory rate, and oxygen saturation, showed no significant changes over time. The quality of delivered ventilation was somewhat variable, but it was stable on the average: average tidal volume ranged between 524.8 and 607.0 mL (p = 0.33). There was a slight but significant increase (7.3-10.9 L/min [p = 0.048]) in minute volume throughout the test period, reaching values consistent with mild hyperventilation. The subjects scored their perceived working effort as very light to fairly light, with a nonsignificant gradual increase in the Borg score as the study progressed.
Manual ventilation of intubated patients can be performed continuously for 6 hours without excessive physical effort on the part of the operator. The quality of delivered ventilation was clinically adequate for all of them. There was a mild but significant trend toward hyperventilation, albeit within safe clinical levels, which was due to an increasing ventilatory rate rather than an increase in tidal volume.
对插管患者进行人工通气是一种常见的干预措施。它需要技巧和体力，通常仅限于短暂的时间。在某些情况下，例如极端大规模伤亡事件，可能需要长时间的人工通气。本研究测试了护士是否能够在 6 小时内适当地对患者进行人工通气。
志愿者在电子模拟器上进行通气 6 小时，同时测量和记录他们自己的心肺变量和输送通气的质量。志愿者使用标准 Borg 量表对他们感知到的努力程度进行评分。
特拉维夫医疗中心急诊科研究实验室。
特拉维夫索拉斯基医疗中心的 10 名护理人员，年龄 25-43 岁。
志愿者手动通气肺模拟器 6 小时。
受试者的生理状态，包括血压、心率、呼吸频率和血氧饱和度，随着时间的推移没有明显变化。输送通气的质量有些不稳定，但平均而言是稳定的：平均潮气量在 524.8 至 607.0 毫升之间（p = 0.33）。整个测试期间，分钟通气量略有但显著增加（7.3-10.9 升/分钟[p = 0.048]），达到轻度过度通气的水平。受试者将他们的工作努力评分评为非常轻到相当轻，随着研究的进展，Borg 评分逐渐增加，但没有统计学意义。
对插管患者进行人工通气可以连续进行 6 小时，而操作者不会感到过度的体力消耗。输送通气的质量对所有人来说都是足够的。尽管处于安全的临床水平内，但存在轻度但显著的过度通气趋势，这是由于通气率的增加而不是潮气量的增加所致。
