title: Single rescuer ventilation using a bag-valve mask with internal handle: a randomized crossover trial.
abstract: OBJECTIVE
  To compare tidal volume received during single rescuer ventilation with a modified bag-valve mask (BVM) with integrated internal handle vs standard BVM among healthy volunteers using a manikin model.
  
  
  METHODS
  This study was a randomized crossover trial of adult healthcare provider volunteers performing ventilation on a manikin. We randomized participants to perform single rescuer ventilation first using either a modified BVM with integrated internal handle or a standard unmodified BVM. Participants were responsible for mask placement and delivery of 10 breaths per minute for 3 minutes as guided by a metronome. After a 3-minute rest period, they performed ventilation using the alternative device. The primary outcome measure was mean received tidal volume as measured by the manikin (IngMar RespiTrainer model). Secondary outcomes included participant reported device preference.
  
  
  RESULTS
  Of 70 recruited participants, all completed the study. Mean received tidal volume was higher using the modified BVM with integrated internal handle vs standard BVM by 90 mL (95% confidence interval, 60-120 mL; P< .0001). There were no significant differences in mean received tidal volume based on the order of study arm allocation. Eighty percent of participants reported preference for the modified BVM over the standard BVM (95% confidence interval, 70.0%-80.0%).
  
  
  CONCLUSIONS
  The modified BVM with integrated internal handle results in greater mean received tidal volume compared with standard BVM during single rescuer ventilation in a manikin model. This modified BVM design may prove a useful airway adjunct for ventilation.
authors: Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX.
authors: Baruch
authors: B
authors: Zobrist
authors: Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX.
authors: Monica
authors: M
authors: Casmaer
authors: Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX. Electronic address: Michael.D.April@post.harvard.edu.
authors: Michael D
authors: MD
authors: April
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008348:Manikins; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D016037:Single-Blind Method; D013990:Tidal Volume; D013997:Time Factors