Excess ventilation with oxygen-powered resuscitators.
Massive subcutaneous emphysema developed in three patients following ventilation with an oxygen-powered, positive pressure resuscitator used by an urban emergency medical service. A faulty valve regulator was identified as the source of the problem. Following this discovery, an extensive field test of all oxygen-powered resuscitators used by the emergency service was carried out. Sixty resuscitators were tested, 15 of which (25%) were found to be deficient on at least one of the test criteria. It is strongly recommended that all personnel using these devices be trained to recognize equipment malfunction and that periodic performance evaluations be carried out on all such equipment. The results of this field test, and other performance tests done previously, raise questions about the use of positive pressure resuscitators in the emergency setting.