AI Article Synopsis
- The study evaluated the skills of various PICU team members in using a flow-inflating bag for manual ventilation through a mobile simulation unit.
- A total of 129 participants completed tasks, revealing that only 4% successfully met defined ventilation criteria, with most feeling uncertain about their skills.
- Team members showed a lack of consistency in achieving target ventilation parameters, especially in maintaining positive end-expiratory pressure (PEEP), highlighting a need for improved training and real-time coaching.
Article Abstract
Objectives: To assess the skill of bag-tube manual ventilation with the flow-inflating bag in multiprofessional PICU team members using a mobile simulation unit.
Design: Prospective observational study from January 2022 to April 2022.
Setting: In situ mobile simulation using the flow-inflating bag in an academic PICU.
Subjects: Multiprofessional PICU team members including nurses, respiratory therapists, nurse practitioners, fellows, and attendings.
Interventions: None.
Measurements And Main Results: We enrolled 129 participants who twice completed 1-minute tasks performing bag-tube manual ventilation with a flow-inflating bag. Sessions were video recorded; four could not be analyzed. Only 30% of participants reported being very to extremely confident, and the majority (62%) reported infrequent skill performance. Task success was defined as achieving target pressure ranges during 80% of the delivered breaths, respiratory rate (RR) of 25-35 breaths/min, and successful pop-off valve engagement. Only five of 129 participants (4%) achieved successful ventilation as defined. Overall, participants were more likely to deliver lower pressures and faster rate. Maintaining target positive end-expiratory pressure (PEEP) was least likely to be achieved (19% success), followed by RR (52%), pop-off valve (64%), then peak inspiratory pressure (71%). Nurses were less likely to achieve target pressures compared with all other professions.
Conclusions: Multiprofessional PICU team members have highly variable self-confidence with bag-tube manual ventilation using a flow-inflating bag. Observed performance demonstrates rare success with achieving targeted ventilation parameters, in particular maintenance of PEEP. Future research should focus on developing mobile simulation units to facilitate profession-specific, real-time coaching to teach high-quality manual ventilation that can be translated to the bedside.
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| http://dx.doi.org/10.1097/PCC.0000000000003612 | DOI Listing |
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