Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
University of Genoa, School of Medical and Pharmaceutical Sciences, Genova, Italy.
Prehosp Disaster Med. 2020 Aug;35(4):358-363. doi: 10.1017/S1049023X20000679. Epub 2020 Jun 1.
Manual ventilation with a bag-valve device (BVD) is a Basic Life Support skill. Prolonged manual ventilation may be required in resource-poor locations and in severe disasters such as hurricanes, pandemics, and chemical events. In such circumstances, trained operators may not be available and lay persons may need to be quickly trained to do the job.
The current study investigated whether minimally trained operators were able to manually ventilate a simulated endotracheally intubated patient for six hours.
Two groups of 10 volunteers, previously unfamiliar with manual ventilation, received brief, structured BVD-tube ventilation training and performed six hours of manual ventilation on an electronic lung simulator. Operator cardiorespiratory variables and perceived effort, as well as the quality of the delivered ventilation, were recorded. Group One ventilated a "normal lung" (compliance 50cmH2O/L, resistance 5cmH2O/L/min). Group Two ventilated a "moderately injured lung" (compliance 20cmH2O/L, resistance 20cmH2O/L/min).
Volunteers' blood pressure, heart rate (HR), respiratory rate (RR), and peripheral capillary oxygen saturation (SpO2) were stable throughout the study. Perceived effort was minimal. The two groups provided clinically adequate and similar RRs (13.3 [SD = 3.0] and 14.1 [SD = 2.5] breaths/minute, respectively) and minute volume (MV; 7.6 [SD = 2.1] and 7.7 [SD = 1.4] L/minute, respectively).
The results indicate that minimally trained persons can effectively perform six hours of manual BVD-tube ventilation of normal and moderately injured lungs, without undue effort. Quality of delivered ventilation was clinically adequate.
使用球囊-面罩（BVM）进行人工通气是基础生命支持技能。在资源匮乏的地区和飓风、大流行、化学事件等严重灾害中，可能需要长时间进行人工通气。在这种情况下，可能没有经过培训的操作人员，而需要迅速培训非专业人员来完成这项工作。
本研究旨在调查未经训练的操作人员是否能够在电子肺模拟器上对模拟经气管插管的患者进行六小时的人工通气。
两组各 10 名志愿者之前不熟悉人工通气，接受了简短的结构化 BVM 管通气培训，并在电子肺模拟器上进行了六小时的人工通气。记录操作人员的心肺变量和感知的努力程度，以及所提供通气的质量。第 1 组通气“正常肺”（顺应性 50cmH2O/L，阻力 5cmH2O/L/min）。第 2 组通气“中度受损肺”（顺应性 20cmH2O/L，阻力 20cmH2O/L/min）。
志愿者的血压、心率（HR）、呼吸频率（RR）和外周毛细血管血氧饱和度（SpO2）在整个研究过程中保持稳定。感知的努力程度很小。两组提供的 RR（分别为 13.3[SD=3.0]和 14.1[SD=2.5]次/分钟）和分钟通气量（MV；分别为 7.6[SD=2.1]和 7.7[SD=1.4]L/分钟）都非常接近临床正常值。
这些结果表明，未经训练的人员可以有效地进行六小时的正常和中度受损肺的人工 BVM 管通气，且不会感到过度劳累。所提供的通气质量具有临床价值。
