title: Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients.
abstract: OBJECTIVE
  To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators.
  
  
  METHODS
  Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, and flows of either 24 or 30 L min(-1). One hundred and four patients were analysed. Induction of anaesthesia followed by ventilation of the lungs with a bag-valve device and an Oxylator in manual and automatic modes performed by a fireman first responder. Each series was repeated for three conditions (anaesthesia; anaesthesia plus muscle relaxation, both with facemask; anaesthesia plus relaxation using an endotracheal tube).
  
  
  RESULTS
  Patients age 49 +/- 17 yr; 47% males, 48-132 kg. Normocapnia was achieved and maintained in 66% (bag-valve device), 82% (Oxylator).
  
  
  CONCLUSIONS
  The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators improves performance (P < 0.001) vs. the bag-valve device significantly.
authors.affiliation: St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands. g.noordergraaf@elisabeth.nl
authors.forename: G J
authors.initials: GJ
authors.lastname: Noordergraaf
authors.forename: P J
authors.initials: PJ
authors.lastname: van Dun
authors.forename: B P
authors.initials: BP
authors.lastname: Kramer
authors.forename: M P
authors.initials: MP
authors.lastname: Schors
authors.forename: H P
authors.initials: HP
authors.lastname: Hornman
authors.forename: W
authors.initials: W
authors.lastname: de Jong
authors.forename: A
authors.initials: A
authors.lastname: Noordergraaf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods; D002245:Carbon Dioxide / Q000097:blood*; D004638:Emergency Treatment / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*; D016037:Single-Blind Method; D012122:Ventilators, Mechanical / Q000706:statistics & numerical data*
chemical_list: D009125:Muscle Relaxants, Central; D002245:Carbon Dioxide