Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients

Eur J Anaesthesiol. 2004 May;21(5):367-72. doi: 10.1017/s0265021504005034.


Background and objective: To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators.

Methods: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, and flows of either 24 or 30 L min(-1). One hundred and four patients were analysed. Induction of anaesthesia followed by ventilation of the lungs with a bag-valve device and an Oxylator in manual and automatic modes performed by a fireman first responder. Each series was repeated for three conditions (anaesthesia; anaesthesia plus muscle relaxation, both with facemask; anaesthesia plus relaxation using an endotracheal tube).

Results: Patients age 49 +/- 17 yr; 47% males, 48-132 kg. Normocapnia was achieved and maintained in 66% (bag-valve device), 82% (Oxylator).

Conclusions: The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators improves performance (P < 0.001) vs. the bag-valve device significantly.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, General / methods
  • Carbon Dioxide / blood*
  • Emergency Treatment / instrumentation
  • Emergency Treatment / methods*
  • Emergency Treatment / statistics & numerical data
  • Female
  • Humans
  • Intubation, Intratracheal
  • Laryngeal Masks
  • Male
  • Middle Aged
  • Muscle Relaxants, Central / therapeutic use
  • Prospective Studies
  • Respiration, Artificial / instrumentation*
  • Respiration, Artificial / methods*
  • Single-Blind Method
  • Ventilators, Mechanical / statistics & numerical data*


  • Muscle Relaxants, Central
  • Carbon Dioxide