Overly aggressive ventilation rates by EMS personnel may be harming patients with compromised circulation, Dallas EMS Medical Director Paul Pepe, MD, said during a session titled "Ventilation of the Critically Ill and Injured" at the EMS Today Conference & Exposition in Salt Lake City March 6. ˙Both basic and advanced ventilatory techniques can be detrimental or even fatal when traditional techniques are followed too zealously,Ó he said.
The conclusion that Milwaukee EMS providers were overventilating CPR patients came as an unexpected finding during the study of a new medical device by researchers Tom Aufderheide, MD, and Ronald Pirrallo, MD (see "Are Your Medics Overventilating Patients?" EMS Insider, April 2004). Aufderheide said the device they are studying includes a display that lights up for one second 12 times a minute to help users properly pace ventilations during CPR. "This can greatly help, and I predict there will be other biomedical-device solutions for this problem."
One new device that may help is the Smart Bag, a new bag-valve mask from O-Two Medical Technologies, Ontario, Canada. If a rescuer squeezes the bag too hard, the Smart Bag closes a valve, which makes squeezing the bag noticeably more difficult and, consequently, forces the rescuer to slow the flow rate; the harder the squeeze, the greater the resistance. By providing this feedback, the bag prompts rescuers to provide slow, well-paced ventilations.
The device does allow the user to increase the pressure required to provide adequate ventilations to patients with restricted airways. In addition, the rescuer may disable the flow restrictor and use the Smart Bag just like a typical bag-valve device.
For more information on the Smart Bag, visitwww.otwo.com. For more information on overventilation of patients, review "Are Your Medics Overventilating Patients?" in April 2004 EMS Insider.
Mannie Garza is editor of the EMS Insider, a Jems publication. She has reported on EMS news for JEMS for more than 15 years.