Due to increasing concern over potential cross-infection during cardiopulmonary resuscitation (CPR), a number of disposable resuscitators have become commercially available. The wearing of disposable medical gloves by persons performing CPR has also become commonplace. In this study, we evaluated the effects of hand size, use of disposable medical gloves, and number of hands used (one versus two) on the volumes delivered by five adult disposable resuscitators.
Method: Persons familiar with bag-valve ventilation were recruited to participate in the study--eight with small hands, eight with medium hands, and eight with large hands. Ventilation was delivered to one side of a Vent-Aid training test lung (TTL), and volumes were measured with a BEAR VM-90. In random order, each participant ventilated the TTL with all combinations of one hand/two hands, gloves/no gloves, and each of the following resuscitators: Code Blue, Hospitak, Pulmanex, Mercury, and Ambu SPUR. The participants were instructed to ventilate the TTL as they would ventilate a patient.
Results: The mean =/- SD volumes (in liters) were small hands = 0.68 +/- 0.15, medium hands = 0.71 +/- 0.18, large hands = 0.81 +/- 0.19 (p=0.006); gloves = 0.73 +/- 0.19, no gloves = 0.73 +/- 0.18 (p=0.80); one hand = 0.62 +/- 0.12, two hands = 0.84 +/- 0.17 (p less than 0.0001); Code Blue = 0.79 +/- 0.14, Hospitak = 0.56 +/- 0.11, Pulmanex = 0.71 +/- 0.15, Mercury = 0.77 +/- 0.18, SPUR = 0.83 +/- 0.2 (p less than 0.0001).
Conclusions: The use of gloves did not significantly affect volume delivery. Delivered volumes did increase significantly as hand size increased and as number of hands used to squeeze the bag increased, and observed differences in volume delivery between brands of resuscitators may be clinically important in some cases. This study emphasizes the importance of squeezing the resuscitator with two hands during bag-valve ventilation.