Precise minute ventilation delivery using a bag-valve mask and audible feedback

Am J Emerg Med. 2012 Sep;30(7):1068-71. doi: 10.1016/j.ajem.2011.07.003. Epub 2011 Sep 9.


Objectives: The efficacy of a modified bag-valve mask (BVM) with a ventilation rate alarm system was compared with conventional BVM to maximize adequate minute ventilation volume delivery in a manikin model.

Methods: After a 30-minute instructional session on how to use the 2 types of BVM, volunteers were randomly assigned to ventilate a manikin in a 2-minute arrest simulation using 2 different types of BVM. The manikin cardiopulmonary resuscitation was performed with a mechanical chest compression device, to which we added a rate alarm, which makes a ticking sound to indicate each second and buzzes every sixth second, to ensure a regular ventilation rate (10 breaths per minute). Fifty-two volunteers attempted to squeeze the classic BVM at a rate of 8 to 10 times per minute during 2-minute trial (volume marked BVM [VBVM]). After a 1-hour break, artificial ventilation was performed at a rate of 9 times per minute with the guidance of the rate alarm (rate and volume adjusted BVM [RVBVM]).

Results: There were no correlations between the data and the participants' physical characteristics or levels of training. In this study, the accuracy of minute ventilation between the 2 groups showed a significant difference (P < .001). The minute ventilation rate was constant in the RVBVM group, whereas in the VBVM group, the minute ventilation rate was irregular.

Conclusion: In a manikin arrest model, the use of RVBVM results in a more constant and regular minute tidal ventilation rate than the use of VBVM and is, therefore, expected to produce more favorable outcomes in practical resuscitative situations.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiopulmonary Resuscitation / instrumentation
  • Cardiopulmonary Resuscitation / methods
  • Clinical Alarms
  • Female
  • Heart Massage
  • Humans
  • Male
  • Manikins
  • Masks
  • Respiration, Artificial / instrumentation
  • Respiration, Artificial / methods*