Journal Article10.1213/01.ANE.0000181833.23904.4E
An audible indication of exhalation increases delivered tidal volume during bag valve mask ventilation of a patient simulator.
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TL;DR: Use of a SIMR with an audible indicator of exhalation significantly (P < 0.001) increased mask ventilation of a patient simulator, suggesting that mask ventilationof a patient with aSIMR may also be increased by objective, real-time feedback of exhaled Vt.
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Abstract: Self-inflating manual resuscitators (SIMRs) can mislead caregivers because the bag, unlike a Mapleson-type device, reinflates even without patient exhalation. We added a whistle as an audible indicator to the exhalation port of a SIMR. In randomized order, each participant provided two sets of breaths via mask ventilation with a SIMR, one with and one without audible feedback, to a Human Patient Simulator modified to log lung volume changes. The last three breaths in each set were used to compare average tidal volume (Vt) under both conditions. Eighty-seven advanced cardiac life support trainees (54 males, 33 females) with clinical experience averaging 6.4 +/- 9.4 yr were recruited. Average Vt delivered with the standard SIMR was 486 +/- 166 mL and 624 +/- 96 mL with the modified SIMR. Average Vt delivered by a modified SIMR was significantly larger by 40% when it followed standard SIMR use and 19% when using the modified SIMR first. Use of a SIMR with an audible indicator of exhalation significantly (P < 0.001) increased mask ventilation of a patient simulator, suggesting that mask ventilation of a patient with a SIMR may also be increased by objective, real-time feedback of exhaled Vt.
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Citations
Noninvasive Positive-Pressure Ventilation
David S.C. Hui,Stephen D. Hall,Matthew T. V. Chan,Benny K. Chow,Jin Yeu Tsou,Gavin M. Joynt,Colin E. Sullivan,Joseph J.Y. Sung +7 more
TL;DR: Substantial exposure to exhaled air occurs within a 0.5-m radius of patients receiving NPPV, and medical wards should be designed with an architectural aerodynamics approach and knowledge of air/particle dispersion from common mechanical ventilatory techniques.
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Exhaled air dispersion during coughing with and without wearing a surgical or N95 mask.
TL;DR: N95 mask was more effective than surgical mask in preventing expelled air leakage during coughing but there was still significant sideway leakage.
175
Exhaled Air Dispersion Distances During Noninvasive Ventilation via Different Respironics Face Masks
David S.C. Hui,Benny K. Chow,Susanna S.S. Ng,Leo Chu,Stephen D. Hall,Tony Gin,Joseph J.Y. Sung,Matthew T. V. Chan +7 more
TL;DR: Substantial exposure to exhaled air occurs within a 1-m region, from patients receiving NPPV via the ComfortFull 2 mask and the Image 3 mask, with more diffuse leakage from the latter, especially at higher IPAP.
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Noninvasive positive-pressure ventilation: An experimental model to assess air and particle dispersion.
David S.C. Hui,Stephen D. Hall,Matthew T. V. Chan,Benny K. Chow,Jin Yeu Tsou,Gavin M. Joynt,Colin E. Sullivan,Joseph J.Y. Sung +7 more
TL;DR: In this paper, an oronasal mask attached to a human-patient simulator (HPS) during noninvasive positive-pressure ventilation (NPPV) was used for visualization.
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Exhaled air and aerosolized droplet dispersion during application of a jet nebulizer.
David S.C. Hui,Benny K. Chow,Leo Chu,Susanna S. Ng,Stephen D. Hall,Tony Gin,Matthew T. V. Chan +6 more
TL;DR: Investigation of the dispersion distances of exhaled air and aerosolized droplets during application of a jet nebulizer to a human patient simulator (HPS) programmed at normal lung condition and different severities of lung injury found that health-care workers should take extra protective precaution within at least 0.8 m from patients with febrile respiratory illness of unknown etiology.
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