Ventilation during cardiopulmonary resuscitation: which method?

A questionnaire was circulated to assess the influence of the presence of vomitus, secretions and infection on the willingness of 70 hospital staff members to use methods of ventilation during cardiopulmonary resuscitation (CPR). The responses showed that only 13% would use mouth-to-mouth and 59% mouth-to-mask ventilation in the presence of these features. Thirty-five of these subjects were then tested for their ability to ventilate a manikin adequately (tidal volume, 800 mL). The best performance was seen with mouth-to-mouth ventilation. After instruction, their performance was satisfactory with mouth-to-mouth and mouth-to-mask resuscitation and with the Robertshaw resuscitator. Bag-valve-mask ventilation had a 97% failure rate before and after instruction and may be inappropriate for CPR. A resuscitation mask which allows effective ventilation without contamination and with oxygen supplementation is the most cost-effective and best accepted method of emergency ventilation.