title: Ventilation performance of a mixed group of operators using a new rescue breathing device-the glossopalatinal tube.
abstract: BACKGROUND
  We studied how effectively a mixed group of helpers could ventilate a manikin with a new rescue breathing device after a short period of instruction. The device consists of a mouthcap, a "glossopalatinal tube" (GPT) reaching between tongue and palate and a connector for a bag, ventilator or the rescuers mouth. Rather than reaching behind the tongue like an oropharyngeal airway (OP), it is able to scoop the tongue off the posterior pharyngeal wall when tilted by the rescuer. It was compared with a conventional face mask with an OP.
  
  
  METHODS
  The study made use of an anaesthesia simulator (MedSim Ltd., Israel) and a manikin. 46 subjects with different professional backgrounds (anaesthesia nurses, medical students, emergency medical technicians (EMTs), physicians training for anaesthesiology) underwent a standard introduction to the GPT and OP (lecture with demonstration on an intubation trainer, illustrated brochure). They ventilated the manikin for 5 min each using the bag plus GPT and the OP plus face mask, respectively, in random order after the simulator had been made apnoeic and the simulated arterial oxygen saturation (S(aO(2))) had dropped to 80%. The actions and the results (tidal volumes (V(t)), S(aO(2))) were recorded on video. The subjects graded difficulty of operation and fatigue on a visual analogue scale (VAS).
  
  
  CONCLUSIONS
  Mean V(t) with the OP plus mask amounted to 463 (230-688 ml), with GPT to 426 (243-610 ml) (median [10-90% percentiles]) (P=0.047). No differences were observed with respect to the time a S(aO(2))> or =90% was maintained (OP plus mask: 255 (139-266 s), GPT: 255 (90-269 s)) or the grades for fatigue (OP plus mask: 58% of VAS, GPT: 48% of VAS, median) and difficulty (OP plus mask: 16% of VAS, GPT: 21% of VAS). Performance and grades were scattered over a wide range. Success with the two devices was correlated, but the subjects judgement tended to diverge. The GPT is an easy to learn alternative to conventional devices and might be helpful in clinical emergencies, including situations of unexpectedly difficult ventilation.
authors: Department of Anaesthesiology, Universitaetsklinikum Hamburg-Eppendorf, Martinistrasse 52, D 20246 Hamburg, Germany. reissman@uke.uni-hamburg.de
authors: Hajo
authors: H
authors: Reissmann
authors: Sven
authors: S
authors: Birkholz
authors: Henning
authors: H
authors: Ohnesorge
authors: Kai
authors: K
authors: Jensen
authors: Stefan
authors: S
authors: Eckert
authors: Axel
authors: A
authors: Nierhaus
authors: Jochen
authors: J
authors: Schulte am Esch
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000193:education*; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D016014:Linear Models; D008297:Male; D008348:Manikins; D011336:Probability; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D013337:Students, Medical