Growing Body of Evidence Links Pre-hospital Use of BVMs to Negative Patient Outcomes

[Anonymous]

http://www.prweb.com/releases/automedx_BVM_EMS/bag-valve_mask_ventilator/prweb9319433.htm

 

[leoemt]

I find it funny that the study from a company that makes automatic ventilators.

Is a BVM perfect? No. However it is simple, effective and requires no power. Until they come up with something better your not going to replace the BVM.

For a patient in respiratory distress, I seriously doubt they care that we are using 50 year old technology.

Automatic ventilators belong in hospitals not in the field.

 

[Meursault]

Growing Body of Evidence Links Reviews Conducted by Device Manufacturers to Overwhelming Bias.

They repackaged a transport vent. I was under the impression those had been tried and abandoned years ago.

Even in their review, it's not convincingly claimed that there's any clinical benefit from their device over the free options: passive ventilation in cardiac arrest and not worrying about it too much in other patients. I also noticed that they say it's contraindicated "when the patient is trying to breathe spontaneously", needs PEEP, or has lung compliance issues. Pretty small population left after that.

 

[Christopher]

http://www.prweb.com/releases/automedx_BVM_EMS/bag-valve_mask_ventilator/prweb9319433.htm

That is a Press Release not a study and the "study" they link to is an article which aggregated information on studies which pretty much all point to hyperventilation as the source of the problem...but I will admit they typically were hyperventilated by a BVM. (insert guns don't kill people "logic" here)

None of those studies show any link with BVM use and a decrease in survival.

In fact, numerous studies show that BVM+mask increases survival!

 

[Handsome Robb]

Automatic ventilators belong in hospitals not in the field.

:blink:

Care to explain this? I use my vent all the time. Consistent rate, tidal volume and frees up a set of hands vs forcing me to take a FF with me and that FF trying to accomplish the same thing with a plastic bag... Don't take this as me hating on fire, been considering it a lot recently but 99 times out of 100 they bag way too fast, which is the whole reason why "Growing Body of Evidence Links Pre-hospital Use of BVMs to Negative Patient Outcomes" is being cited in this post.

edited to finish my thought process

 

[Christopher]

Automatic ventilators belong in hospitals not in the field.

That's a pretty bold assertion. I'd give up CAD and go back to map books only for an Oxylog 1000...

 

[Smash]

That's a pretty bold assertion. I'd give up CAD and go back to map books only for an Oxylog 1000...

We use LTVs on our whirlybirds. :wub:

 

[WTEngel]

Automatic ventilators belong in hospitals not in the field.

Respectfully disagree.

I agree with the main point of the article, which is that pre-hospital providers (and many IN HOSPITAL providers) are woefully inadequate at providing proper, effective, rate appropriate BVM ventilation.

The key is better training on the use of BVM, not some fancy device.

AHA has placed emphasis on BVM training and rate control in the current ACLS curriculum. Unfortunately, most instructors are glossing over this because they don't understand the importance, and therefore, can't explain, V/Q matching and its importance in resuscitation and peri arrest management.

 

[mycrofft]

The article is an infomercial not a refence piece. The Circulation article would be better. PR Web bills itself as a publicity medium and hence has no peer review nor review of any kind except maybe length, degree of offensiveness and spellcheck.
Search on CIRCULATION for "bag valve mask" yielded these:

http://circ.ahajournals.org/search?fulltext=BAg+valve+mask&submit=yes&x=0&y=0


Included are multiple articles about how well pre-hops BVM works.

Search for Aufderheide yielded this:

http://circ.ahajournals.org/search?fulltext=Aufderheide&submit=yes&x=0&y=0

No articles by Aufderheide alone.

Sorta

We have all seen badly used BVM's, just as we have all seen badly driven ambulances and badly done CPR. WHen then choice is "this or worse", go with "this".

 

[Akulahawk]

Give me a choice between a BVM and an ATV, I'd rather use the ATV. An ATV isn't the optimal choice either, but I'd prefer the consistency of that over having someone eventually fatigue.

 

[EpiEMS]

What are your transport times like that you prefer an ATV rather than a BVM? Granted, I understand that an ATV is probably preferable to a BVM.

 

[Christopher]

What are your transport times like that you prefer an ATV rather than a BVM? Granted, I understand that an ATV is probably preferable to a BVM.

15 minutes.

 

[EpiEMS]

15 minutes.

Yeah, that's about the same as mine. Maybe it's an issue of patient mix -- I rarely find myself BVM'ing patients and when I do, I usually have at least one other EMT and a medic in the back with me.

 

[TheLocalMedic]

New headline: Patients Who Require CPR Shown To Be Less Likely To Survive Than Those Who Don't!

 

[leoemt]

:blink:

Care to explain this? I use my vent all the time. Consistent rate, tidal volume and frees up a set of hands vs forcing me to take a FF with me and that FF trying to accomplish the same thing with a plastic bag... Don't take this as me hating on fire, been considering it a lot recently but 99 times out of 100 they bag way too fast, which is the whole reason why "Growing Body of Evidence Links Pre-hospital Use of BVMs to Negative Patient Outcomes" is being cited in this post.

edited to finish my thought process

I have never seen a field automatic vent other than the ones used for neo nates.

I meant, I can't imagine an automatic vent being dragged into an overturned car to be used on a patient. However a BVM can be used.

I don't have experience with them because I don't use them. We use BVMs.

Maybe its a training issue. I can tell you that we have a feedback manequin and only about 1% of my ventilations are wrong. I train like I play and I play like I train so I do it the same in the field as I do in training.

Instead of questioning someone who obviously has limited experience with something, why not take the time to educate. Thought that was the whole point of this site anyways.

 

[Anonymous]

New headline: Patients Who Require CPR Shown To Be Less Likely To Survive Than Those Who Don't!

Hey start your own thread buddy :huh:

 

[RocketMedic]

I find it funny that the study from a company that makes automatic ventilators.

Is a BVM perfect? No. However it is simple, effective and requires no power. Until they come up with something better your not going to replace the BVM.

For a patient in respiratory distress, I seriously doubt they care that we are using 50 year old technology.

Automatic ventilators belong in hospitals not in the field.

A properly used ventilator is far, far better and more consistent than a BVM.

 

[RocketMedic]

I have never seen a field automatic vent other than the ones used for neo nates.

I meant, I can't imagine an automatic vent being dragged into an overturned car to be used on a patient. However a BVM can be used.

I don't have experience with them because I don't use them. We use BVMs.

Maybe its a training issue. I can tell you that we have a feedback manequin and only about 1% of my ventilations are wrong. I train like I play and I play like I train so I do it the same in the field as I do in training.

Instead of questioning someone who obviously has limited experience with something, why not take the time to educate. Thought that was the whole point of this site anyways.

http://www.emsworld.com/company/10068955/impact-instrumentation-inc

Portable, effective, and efficient. CPAP, BiPAP, Assist-Control and straight command ventilation, quiet, decent battery life, and adjustable almost-everything, plus enough alarms to drive you crazy. It's a great tool and it's way easier to deploy than a human. Honestly, in your Trapped Patient of Doom scenario, if we're talking BVM, it's easier and far safer to the rescuer to intubate this patient, secure the tube, and deploy the AEV with hoses connecting to the ET tube than it is to thrash about ventilating by hand.

Heck, we've even got a Manual Breath button. Thumbs get way less tired than hands.

 

[VFlutter]

Automatic ventilators belong in hospitals not in the field.

I have never seen a field automatic vent other than the ones used for neo nates.

I don't have experience with them because I don't use them. We use BVMs.

Maybe its a training issue. I can tell you that we have a feedback manequin and only about 1% of my ventilations are wrong. I train like I play and I play like I train so I do it the same in the field as I do in training.

Instead of questioning someone who obviously has limited experience with something, why not take the time to educate. Thought that was the whole point of this site anyways.

You are making a pretty bold statement for not having any experience with them.

I am curious what you mean about mannequin feedback, what exactly does it tell you? And where did you get 1% from? How long can you do perfect BVM ventilations? Performing in a controlled environment with perfect anatomy doesn't mean much in the real world.

People are questioning you because you made a very opinionated statement that most people disagree with. This site is all about education.

 

[NomadicMedic]

A transport vent is easy to set for a consistent tidal volume, can maintain a set ETCO2, and it doesn't get in my way or need a ride back to the firehouse.

Also easier than trying to bag a patient in the helicopter for 45 minutes. :/ an you say "hand cramp"