PubMed Health⌕ Search

Biomedical subjects

Melissa De Regge

Publications and source records attributed to Melissa De Regge.

2 recordsLinked to original sources
PubMed2005

Retention of ventilation skills of emergency nurses after training with the SMART BAG compared to a standard bag-valve-mask.

BACKGROUND AND PURPOSE: Studies show that nurses retain resuscitation skills poorly and that retention of ventilation skills is particularly difficult. We formed the hypothesis that the SMART BAG (SB, O-Two Medical Technologies Inc., Canada), i.e. a bag-valve-mask device with a pressure/flow responsive valve, would assist nurses in providing more efficient ventilation six months after training. MATERIALS AND METHODS: Prior to training, 39 emergency nurses performed CPR for 2 min, in pairs, using a standard bag-valve-mask device (STBVM, Laerdal, Norway) to assess their base line skills. A CPR training manikin (Simulaids, USA) equipped with a PEEP valve in the oesophagus set at 20 cm H2O was used to measure inspiratory time, tidal volume (Vt), peak pressure and gastric insufflation (GI). Immediately following training they were tested using an O-Two STBVM and a SB. Half of the nurses were retested after three months, the other half after six months. Efficient ventilation was defined as a mean Vt>400 ml and GI<50 ml in 1 min. RESULTS: Before training, only 16% of nurses ventilated efficiently: 63% had GI and 28% had Vt<400 ml. Three months after training the efficiency of the STBVM and the SB was high (81 and 75%, respectively). Six months after training, there was a trend towards higher efficiency for the SB (63%) compared to the STBVM (25%) (p=0.07). For instances with the STBVM producing a Vt>400 ml, those without GI had a lower peak pressure than those with GI (7.8 cm H2O versus 17.7 cm H2O, p=0.0001) and showed a trend towards a longer inspiratory time (1.28 s versus 1.08 s, p=0.08). Of all efficient ventilations with a STBVM, 26% had a Vt>600 ml. CONCLUSIONS: Six months after training, nurses ventilated at least as efficiently with the SB, compared with the STBVM. This illustrates the ability of the SB to compensate for the deterioration over time in skill. On the other hand, training with a STBVM should focus primarily on prolonging the inspiratory time, and therefore the peak pressure, whilst maintaining an adequate Vt.

Adult↗
PubMed2005

Improved basic life support performance by ward nurses using the CAREvent Public Access Resuscitator (PAR) in a simulated setting.

INTRODUCTION: The CAREvent Public Access Resuscitator (PAR, O-Two Medical Technologies, Ontario, Canada) is a new oxygen-driven device alternating two ventilations with 15 prompts for chest compressions. The PAR is designed for use with a standard resuscitation face mask and is equipped with mask leakage and obstruction alarms. The purpose of this study was to assess the quality of basic life support (BLS) by hospital nurses and to evaluate if BLS with the PAR is better than BLS using the mouth-to-mask technique. METHODS: The study group consisted of 352 nurses from Ghent University Hospital working outside the critical care and emergency departments. BLS skills were measured using a Laerdal Skillreporter manikin (Laerdal, Norway) connected to a Laerdal PC Skillreporting system. To assess base line skills, 200 nurses were tested without previous notice in single rescuer BLS using a pocket mask (PM, Laerdal, Norway) or a bag-valve mask device (Laerdal, Norway) over a period of 2 min. A separate consecutive sample of 152 nurses was randomised to the PM or PAR groups after a standard BLS refresher course. The PAR group received a short period of training in PAR use. Immediately after training, both groups performed the 2 min single rescuer BLS test. RESULTS: Unprepared nurses achieved only 26 compressions and 3 ventilations/min. Immediately after training, nurses using the PAR delivered 54 compressions/min as opposed to 35 for the PM group (p<0.0001). PAR users ventilated six times/min compared to five times for PM users (p<0.0001). CONCLUSION: Immediately after training, the use of the PAR improved BLS performance by ward nurses significantly, bringing the number of ventilations and compressions per minute close to the theoretical maximum achievable within the current guidelines. Retention tests after 6 and 12 months will show if the effect is sustained.

Adult↗