title: Face mask ventilation: a comparison of three techniques.
abstract: BACKGROUND
  There are multiple techniques for face-mask (FM) ventilation. To our knowledge, the one-handed vs. two-handed C-E technique has been compared in children and adults, but no studies have compared the various two-handed methods.
  
  
  OBJECTIVE
  To compare the effectiveness of mask seal using three different FM techniques on a model intended to simulate difficult FM ventilation and measure ventilation performance.
  
  
  METHODS
  This was a prospective randomized study of health care providers. A standard airway-training mannequin was modified to produce variable airway resistance and allow measurements of ventilation volume and pressure. Each subject performed FM ventilation for 3 min per technique (30 breaths) in a randomized order. Median exhaled tidal volume and proximal peak flow pressure were determined and compared.
  
  
  RESULTS
  Seventy subjects were enrolled. Both two-handed ventilation techniques were more effective than the one-handed technique by both volume and pressure measurements. The one-handed C-E technique yielded a median volume of 428.4 mL, vs. the two-handed C-E technique with 550.8 mL, and the two-handed V-E technique with 538 mL (p < 0.001). Peak pressure measurements revealed a median of 54.6 cm H2O for the one-handed C-E technique, 66 cm H2O for the two-handed C-E technique, and 66.6 cm H2O for the two-handed V-E technique (p < 0.001). There was not a difference between the various two-handed techniques.
  
  
  CONCLUSIONS
  This model for FM ventilation is able to differentiate the efficacy of FM techniques. Both two-handed ventilation methods were superior to one-handed ventilation, both of which should perhaps be included in airway training for health care providers.
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Hart
authors.forename: Robert
authors.initials: R
authors.lastname: Reardon
authors.forename: Christopher
authors.initials: C
authors.lastname: Ward
authors.forename: James
authors.initials: J
authors.lastname: Miner
mesh_terms: D006801:Humans; D008348:Manikins; D008397:Masks; D010366:Peak Expiratory Flow Rate; D011446:Prospective Studies; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D013990:Tidal Volume