Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-06-03T00:13:22.759Z Has data issue: false hasContentIssue false
  • English
  • Français

Mouth-to-Mouth Ventilation of Cardiac Arrested Humans Using a Barrier Mask

Published online by Cambridge University Press:  28 June 2012

Kirk C. Lufkin  and
Ernest Ruiz
Kirk C. Lufkin
Affiliation:
St. Luke's Hospital, Duluth, Minn.
Ernest Ruiz*
Affiliation:
Assistant Professor of Surgery, University of Minnesota, Minneapolis, Minn., Emergency Department, Hennepin County Medical Center, Minneapolis, Minn.
*
University of Minnesota, Emergency Department, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Concern for possible disease transmission during mouth-to-mouth resuscitation has decreased the incidence of bystander cardiopulmonary resuscitation (CPR). Barrier masks have become available that may be effective in CPR as well as protective against cross-contamination.

Hypothesis:

A silicone rubber barrier mask incorporating a one-way-valved airway (Kiss of Life [KOL]) designed to prevent contamination of the rescuer, permits satisfactory mouth-to-mouth ventilation of victims of cardiopulmonary arrest.

Methods:

Ten adult patients who did not survive non-traumatic cardiac arrest were ventilated with exhaled room air using a KOL barrier mask while external cardiac massage continued. Arterial blood gases were obtained every two minutes for a maximum of 10 minutes. The operator was blinded to the results of these blood tests.

Results:

Eight men and two women with ages from 55 to 99 years were studied. Four patients were edentulous and two of these had marked mandibular atrophy. The two patients with mandibular atrophy were poorly ventilated with the barrier mask. One other patient was not ventilated successfully. This patient had undergone multiple attempts at endotracheal intubation and had transtracheal needle ventilation performed prior to use of the barrier mask. One patient had elevated PaCO2 despite being well-ventilated clinically. Six patients were ventilated well clinically and had satisfactory PaCO2 and PaO2 values.

Conclusion:

The barrier mask studied appears to be an effective aid to ventilation in CPR Patients without facial support, as in edentulous patients with mandibular atrophy, are not ventilated well with this device.

Keywords

barrier-maskbystandercardiac arrestCPRcross-contaminationhepatitisHIVinfectionmouth-to-mouth ventilationventilation
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 8 , Issue 4 , December 1993 , pp. 333 - 335
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Don Michael, A, Forrester, JS: Mouth-to mouth ventilation: The dying art. Am J Emerg Med 1992:10:156–161.CrossRefGoogle Scholar
2. Copley, DP, Mantle, JA, Rogers, WJ et al. : Improved outcome for prehospital cardiopulmonary collapse with resuscitation by bystanders. Circulation 1977;56:901–905.CrossRefGoogle ScholarPubMed
3. Cummins, RO, Eisenberg, MS: Prehospital cardiopulmonary resuscitation. Is it effective? JAMA 1985;253:2408–2412.CrossRefGoogle ScholarPubMed
4. Grauer, K, Kravitz, L: On mouth-to-mouth. J Am Board Fam Pract 1988;1:55–56.Google ScholarPubMed
5. Anonymous: What our readers said about resuscitating a patient with AIDS. Nursing Life 1986;23–25. (readers poll).Google Scholar
6. Cummins, RO: Infection control guidelines for CPR providers. JAMA 1989;262:2732–2733. Editorial.Google ScholarPubMed
7. Center for Disease Control. HIV seroprevalence among adults treated for cardiac arrest before reaching a medical facility. MMWR 1992;41:381–383.Google Scholar
8. Safar, P, Escarraga, LA, Elam, JO: A comparison of the mouth-to mouth and mouth-to-airway methods of artificial respiration with the chest pressure arm-lift methods. N Engl J Med 1958;258:671–677.Google ScholarPubMed
9. Cydulka, RK, Connor, PJ, Myers, TF et al. : Prevention of oral bacterial flora transmission by using mouth-to-mask ventilation during CPR. J Energ Med 1991:9:317–321.Google ScholarPubMed
10. Guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). JAMA 1992:268:2172–2183.CrossRefGoogle Scholar
11. Lightsey, DM, Prediman, KS, Forrester, JS, Don Michael, TA: A human immunodeficiency virus resistant airway for cardiopulmonary resuscitation. Am J Emerg Med 1992;10:73–77.CrossRefGoogle ScholarPubMed