Comparison of Airway Control Methods and Ventilation Success with an Automatic Resuscitator

Mechanical ventilation in an austere environment is difficult owing to logistics, training, and environmental conditions. We evaluated the ability of professional caregivers to provide ventilatory support to a simulated patient using the Simplified Automated Ventilator SAVe with a mask hand attended ventilation, mask with single strap unattended ventilation, and supraglottic airway King LT ventilation. All three methods were performed using a SAVe with a set tidal volume of 600 mL and respiratory rate of 10 breaths per minute. The simulator consisted of a head and upper torso with anatomically correct upper airway structures, trachea, esophagus, and lung that also measured the delivered tidal volume, respiratory rate, inspiratory flow, and airway pressures. Volunteers used each airway control method to provide ventilation for 10 minutes in random order. Success of each technique was judged as a mean delivered tidal volume of greater than 500 mL. The major finding of this study was that medical professionals using the SAVe resuscitator and the manufacturer-supplied face mask with single head strap failed to ventilate the airway model in every case.