Safety and applicability of a pre-stage public access ventilator for trained laypersons: a proof of principle study

Autor: Jens Schwarz, Svend Kamysek, Patricia Fuchs, Hannes Nierath, Henning Jurs, Juliane Obermeier, Jochen K. Schubert, Martin Becker, Hartmut Ewald, Martin Degner
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Resuscitation
Emergency Medical Services
business.product_category
lcsh:Special situations and conditions
Pressure controlled ventilation
Pilot Projects
Differential pressure
030204 cardiovascular system & hematology
Prototype respirator
Airway occlusion
Public access
03 medical and health sciences
Young Adult
0302 clinical medicine
medicine
Humans
Respirator
Ventilators
Mechanical
business.industry
lcsh:RC952-1245
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Basic life support
030208 emergency & critical care medicine
lcsh:RC86-88.9
Middle Aged
Lay resuscitation
Respiration
Artificial
Airway Obstruction
Proof of concept
Emergency medicine
Emergency Medicine
Female
Patient Safety
business
Out-of-Hospital Cardiac Arrest
Research Article
Zdroj: BMC Emergency Medicine
BMC Emergency Medicine, Vol 17, Iss 1, Pp 1-8 (2017)
ISSN: 1471-227X
Popis: Background Contemporary resuscitation guidelines for basic life support recommend an immediate onset of cardiac compressions in case of cardiac arrest followed by rescue breaths. Effective ventilation is often omitted due to fear of doing harm and fear of infectious diseases. In order to improve ventilation a pre-stage of an automatic respirator was developed for use by laypersons. Methods Fifty-two healthy volunteers were ventilated by means of a prototype respirator via a full-face mask in a pilot study. The pre-stage public access ventilator (PAV) consisted of a low-cost self-designed turbine, with sensors for differential pressure, flow, FO2, FCO2 and 3-axis acceleration measurement. Sensor outputs were used to control the respirator and to recognize conditions relevant for efficiency of ventilation and patients’ safety. Different respiratory manoeuvres were applied: a) pressure controlled ventilation (PCV), b) PCV with controlled leakage and c) PCV with simulated airway occlusion. Sensor signals were analysed to detect leakage and airway occlusion. Detection based upon sensor signals was compared with evaluation based on clinical observation and additional parameters such as exhaled CO2. Results Pressure controlled ventilation could be realized in all volunteers. Leakage was recognized with 93.5% sensitivity and 93.5% specificity. Simulated airway occlusion was detected with 91.8% sensitivity and 91.7% specificity. Conclusion The pre-stage PAV was able to detect potential complications relevant for patients’ safety such as leakage and airway occlusion in a proof of principle study. Prospectively, this device provides a respectable basis for the development of an automatic emergency respirator and may help to improve bystander resuscitation. Electronic supplementary material The online version of this article (10.1186/s12873-017-0150-5) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
Externí odkaz: