It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks
Introduction: A bag valve mask (BVM) is a life saving device used by all levels of health care professionals during resuscitative care. We focus most of our time optimizing the patient’s position, firmly securing the mask, and frequency of ventilations. However, despite our best efforts to control t...
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doaj-0f80aa9b5dcf4f2fac16d0ea9d7235532020-11-25T03:16:40ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182020-04-0121310.5811/westjem.2020.3.45788wjem-21-722It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve MasksBenjamin Dafilou0Daniel Schwester1Nathan Ruhl2Andreia Marques-Baptista3Capital Health Hospital System, Department of Emergency Medical Services, Trenton, New JerseyCapital Health Hospital System, Department of Emergency Medical Services, Trenton, New JerseyRowan University, Department of Biological Sciences, Glassboro, New JerseyCapital Health Hospital System, Department of Emergency Medical Services, Trenton, New JerseyIntroduction: A bag valve mask (BVM) is a life saving device used by all levels of health care professionals during resuscitative care. We focus most of our time optimizing the patient’s position, firmly securing the mask, and frequency of ventilations. However, despite our best efforts to control these factors, we may still be precipitating harm to the patient. Multiple studies have shown the tidal volumes typically delivered by the adult BVM are often higher than recommended for lung-protective ventilation protocols. In this study we measure and compare the ventilation parameters delivered by the adult and pediatric BVM ventilators. Methods: A RespiTrainer Advance® adult mannequin was used to simulate a patient. Healthcare providers were directed to manually ventilate an intubated mannequin for two minutes using adult and pediatric sized BVMs. Tidal volume, minute ventilation, peak pressure, and respiration rate was recorded. Results: The adult BVM provided a mean tidal volume of 807.7mL versus the pediatric BVM providing 630.7mL, both of which exceeded the upper threshold of 560mL of tidal volume necessary for lung protective ventilation of an adult male with an ideal body weight of 70kg. The adult BVM exceeded this threshold by 44.2% versus the pediatric BVM’s 12.6% with 93% of participants exceeding the maximum threshold with the adult BVM and 82.3% exceeding it with the pediatric BVM. Conclusion: The pediatric BVM in our study provided far more consistent and appropriate ventilation parameters for adult patients compared to an adult BVM, but still exceeded the upper limits of lung protective ventilation parameters. The results of this study highlight the potential dangers in using an adult BVM due to increased risk of pulmonary barotrauma. These higher tidal volumes can contribute to lung injury. This study confirms that smaller BVMs may provide safer ventilatory parameters. Future studies should focus on patient-centered outcomes with BVM.https://escholarship.org/uc/item/37z118tt |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benjamin Dafilou Daniel Schwester Nathan Ruhl Andreia Marques-Baptista |
spellingShingle |
Benjamin Dafilou Daniel Schwester Nathan Ruhl Andreia Marques-Baptista It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks Western Journal of Emergency Medicine |
author_facet |
Benjamin Dafilou Daniel Schwester Nathan Ruhl Andreia Marques-Baptista |
author_sort |
Benjamin Dafilou |
title |
It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks |
title_short |
It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks |
title_full |
It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks |
title_fullStr |
It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks |
title_full_unstemmed |
It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks |
title_sort |
it’s in the bag: tidal volumes in adult and pediatric bag valve masks |
publisher |
eScholarship Publishing, University of California |
series |
Western Journal of Emergency Medicine |
issn |
1936-9018 |
publishDate |
2020-04-01 |
description |
Introduction: A bag valve mask (BVM) is a life saving device used by all levels of health care professionals during resuscitative care. We focus most of our time optimizing the patient’s position, firmly securing the mask, and frequency of ventilations. However, despite our best efforts to control these factors, we may still be precipitating harm to the patient. Multiple studies have shown the tidal volumes typically delivered by the adult BVM are often higher than recommended for lung-protective ventilation protocols. In this study we measure and compare the ventilation parameters delivered by the adult and pediatric BVM ventilators. Methods: A RespiTrainer Advance® adult mannequin was used to simulate a patient. Healthcare providers were directed to manually ventilate an intubated mannequin for two minutes using adult and pediatric sized BVMs. Tidal volume, minute ventilation, peak pressure, and respiration rate was recorded. Results: The adult BVM provided a mean tidal volume of 807.7mL versus the pediatric BVM providing 630.7mL, both of which exceeded the upper threshold of 560mL of tidal volume necessary for lung protective ventilation of an adult male with an ideal body weight of 70kg. The adult BVM exceeded this threshold by 44.2% versus the pediatric BVM’s 12.6% with 93% of participants exceeding the maximum threshold with the adult BVM and 82.3% exceeding it with the pediatric BVM. Conclusion: The pediatric BVM in our study provided far more consistent and appropriate ventilation parameters for adult patients compared to an adult BVM, but still exceeded the upper limits of lung protective ventilation parameters. The results of this study highlight the potential dangers in using an adult BVM due to increased risk of pulmonary barotrauma. These higher tidal volumes can contribute to lung injury. This study confirms that smaller BVMs may provide safer ventilatory parameters. Future studies should focus on patient-centered outcomes with BVM. |
url |
https://escholarship.org/uc/item/37z118tt |
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