A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators.
BACKGROUND
Mechanical ventilation is an important part of emergency medicine and is frequently used for transportation. Human errors during ventilator settings are frequent and may be associated with high morbidity/mortality. The aim of the study was to provide a complete ergonomic evaluation of emergency and transport ventilators, taking into account objective and subjective human-machine interface assessments and individual mental work load.


METHODS
We performed a prospective bench ergonomic evaluation of 13 emergency and transport ventilators, using standardized conditions and a global methodological approach. The study was performed in an evaluation laboratory dedicated to respiratory care, and 12 emergency physicians unfamiliar with the tested devices were included in the evaluation. The ventilators were classified into 3 categories (simple, sophisticated, and ICU-like). Objective chronometric evaluations were conducted considering 9 tasks, and subjective evaluations were performed (ease of use, willingness to use, and user-friendliness of monitoring) using Likert scales. Mental work load evaluation was performed using the NASA Task Load Index scale.


RESULTS
Overall task failure rate represented 4% of all attempts. Setting modifications, ventilation mode changes, and powering down durations were different between simple and other emergency and transport ventilator categories (P < .005). There was no difference between ventilator categories for the ease of use and user-friendliness of the monitoring. In contrast, the willingness to use was lower for simple devices, compared with sophisticated and ICU-like emergency and transport ventilators (2.9 ± 1.4 vs 3.9 ± 1.2, P = .002 and 4.3 ± 1, P < .001). No differences were observed between devices regarding the mental work load, except for several specific devices in the sophisticated category.


CONCLUSIONS
A comprehensive ergonomic evaluation provides valuable information while investigating operational friendliness in emergency and transport ventilators. The choice of a device not only depends on its technical characteristics but should take into account its clinical operational setting and ergonomics in order to decrease mental work load. Sophisticated emergency and transport ventilators should only be used by clinicians who demonstrate expertise in mechanical ventilation.
Urgences Adultes, CHRU de Brest, Brest Cedex, France.
Nicolas
N
Marjanovic
Réanimation Médicale, CHRU de Brest, Brest Cedex, France and CESIM/LATIM INSERM UMR 1101, Université de Bretagne Occidentale, Rue Camille Desmoulins, Brest, France. erwan.lher@chu-brest.fr.
Erwan
E
L'Her
D004867:Equipment Design; D006804:Ergonomics; D006801:Humans; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation*; D012122:Ventilators, Mechanical
bench; emergency ventilators; ergonomics; mental workload