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 versus 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 ten breaths per minute for three minutes as guided by a metronome. After a three-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 subject 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 versus 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 subjects 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 to standard BVM during single rescuer ventilation in a manikin model. This modified BVM design may prove a useful airway adjunct for ventilation.