title: E-O technique is superior to E-C technique in manikins during single person bag mask ventilation performed by novices.
abstract: Conventional E-C technique of mask holding is unreliable during single person bag mask ventilation (BMV) due mainly to leak around the mask and inexperience of the persons. In this manikin study, conventional E-C technique was compared with E-O technique during single person BMV both with experienced (n = 50) and novice (n = 50) volunteers. The E-O technique involved encircling the mask neck with the web between thumb and index finger while the other digits provided chin lift. Two independent observers recorded the chest expansion as 1 (nil), 2 (minimal), 3 (moderate) and 4 (good). For analysis ideal and average chest expansion were clubbed as acceptable. E-C technique in experienced volunteers showed acceptable results in 49 (31 + 18) occasions, while with novices acceptable is 39 (17 + 22). With E-O technique, expansion was acceptable in 47 (38 + 9) experienced volunteers, and acceptable in 46 (32 + 14) novices. (P = 0.003). In cross over analysis for experienced volunteers, similar chest expansion was obtained on 30 occasions with both techniques, E-C better than E-O on 8 and E-O better than E-C on 12 occasions. Novices had comparable results on 17 occasions, E-C better than E-O on 8 and E-O better than E-C on 25 occasions (P = 0.016). The conventionally taught E-C technique of single person BMV provides acceptable chest expansion on most occasions with experienced operators than novices. Novices should use E-O technique as the first choice for single person BMV. Both techniques may be used interchangeably when one fails.
authors.affiliation: Department of Anaesthesia, Kasturba Hospital, Kasturba Medical College, Manipal University, Manipal, 576104, India, drumeshg@yahoo.co.in.
authors.forename: Goneppanavar
authors.initials: G
authors.lastname: Umesh
authors.forename: Rohith
authors.initials: R
authors.lastname: Krishna
authors.forename: Souvik
authors.initials: S
authors.lastname: Chaudhuri
authors.forename: Thomas Joseph
authors.initials: TJ
authors.lastname: Tim
authors.forename: Rao
authors.initials: R
authors.lastname: Shwethapriya
mesh_terms: D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000295:instrumentation / Q000379:methods; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007194:India; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data*; D017214:Laryngeal Masks / Q000706:statistics & numerical data*; D008297:Male; D008348:Manikins; D008875:Middle Aged; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data*; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D055815:Young Adult