A randomised controlled trial of bag–valve–mask teaching techniques

Charlotte Strzelecki, Cliff L. Shelton, Jennifer Cunningham, Charlotte Dean, Sameera Naz-Thomas, Katie Stocking, Adam Dobson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

SUMMARY Background: Bag–valve–mask (BVM) ventilation is a vital skill in the management of the collapsed patient; however, the quality of BVM ventilation is a cause for concern. Modified techniques, designed to be easier for the novice practitioner, offer an opportunity to improve quality. One such modification is the ‘LASOO’ (Lift, Apply, Slide, Oppose, Observe) approach, which offers theoretical benefits over the traditionally taught ‘CE’ (finger shapes) technique. We conducted a randomised controlled trial (RCT) to determine whether LASOO was superior to CE in terms of tidal volume, when taught to novices in the skills- lab setting. Methods: A total of 76 undergraduate health care students received a manikin- based teaching session on LASOO or CE. They then delivered 20 breaths (10 with each hand) to a modified airway manikin. The primary outcome was mean tidal volume; secondary outcomes were the proportion of breaths that achieved 150- mL and 400- mL threshold volumes. Subgroup analyses and statistical modelling were conducted for time-point, hand dominance and hand size. Results: The mean tidal volume was 320 mL for CE and 304 mL for LASOO. The median percentage of attempts that exceeded 150 mL was 85 for CE and 82.5 for LASOO. The median percentage of attempts that exceeded 400 mL was 20 for CE and 20 for LASOO. The differences recorded between the techniques were not statistically significant. There was a small, statistically significant increase in tidal volume across both techniques with time-point and holding the mask with the non- dominant hand. Discussion: LASOO is a viable alternative to CE. Educators may opt to teach either or both techniques, allowing students to choose the technique that they prefer.
Original languageEnglish
JournalThe Clinical Teacher
Early online date27 Feb 2019
DOIs
Publication statusE-pub ahead of print - 27 Feb 2019

Fingerprint

Tidal Volume
Teaching
Randomized Controlled Trials
Hand
Manikins
Ventilation
Students
Masks
Fingers
Delivery of Health Care

Keywords

  • A randomised controlled trial of bag–valve–mask teaching techniques

Cite this

Strzelecki, C., Shelton, C. L., Cunningham, J., Dean, C., Naz-Thomas, S., Stocking, K., & Dobson, A. (2019). A randomised controlled trial of bag–valve–mask teaching techniques. The Clinical Teacher. https://doi.org/10.1111/tct.13008
Strzelecki, Charlotte ; Shelton, Cliff L. ; Cunningham, Jennifer ; Dean, Charlotte ; Naz-Thomas, Sameera ; Stocking, Katie ; Dobson, Adam. / A randomised controlled trial of bag–valve–mask teaching techniques. In: The Clinical Teacher. 2019.
@article{8968d1c35c55422e95462a851129c59d,
title = "A randomised controlled trial of bag–valve–mask teaching techniques",
abstract = "SUMMARY Background: Bag–valve–mask (BVM) ventilation is a vital skill in the management of the collapsed patient; however, the quality of BVM ventilation is a cause for concern. Modified techniques, designed to be easier for the novice practitioner, offer an opportunity to improve quality. One such modification is the ‘LASOO’ (Lift, Apply, Slide, Oppose, Observe) approach, which offers theoretical benefits over the traditionally taught ‘CE’ (finger shapes) technique. We conducted a randomised controlled trial (RCT) to determine whether LASOO was superior to CE in terms of tidal volume, when taught to novices in the skills- lab setting. Methods: A total of 76 undergraduate health care students received a manikin- based teaching session on LASOO or CE. They then delivered 20 breaths (10 with each hand) to a modified airway manikin. The primary outcome was mean tidal volume; secondary outcomes were the proportion of breaths that achieved 150- mL and 400- mL threshold volumes. Subgroup analyses and statistical modelling were conducted for time-point, hand dominance and hand size. Results: The mean tidal volume was 320 mL for CE and 304 mL for LASOO. The median percentage of attempts that exceeded 150 mL was 85 for CE and 82.5 for LASOO. The median percentage of attempts that exceeded 400 mL was 20 for CE and 20 for LASOO. The differences recorded between the techniques were not statistically significant. There was a small, statistically significant increase in tidal volume across both techniques with time-point and holding the mask with the non- dominant hand. Discussion: LASOO is a viable alternative to CE. Educators may opt to teach either or both techniques, allowing students to choose the technique that they prefer.",
keywords = "A randomised controlled trial of bag–valve–mask teaching techniques",
author = "Charlotte Strzelecki and Shelton, {Cliff L.} and Jennifer Cunningham and Charlotte Dean and Sameera Naz-Thomas and Katie Stocking and Adam Dobson",
year = "2019",
month = "2",
day = "27",
doi = "10.1111/tct.13008",
language = "English",
journal = "The Clinical Teacher",
issn = "1743-498x",
publisher = "Wiley",

}

A randomised controlled trial of bag–valve–mask teaching techniques. / Strzelecki, Charlotte; Shelton, Cliff L.; Cunningham, Jennifer; Dean, Charlotte; Naz-Thomas, Sameera; Stocking, Katie; Dobson, Adam.

In: The Clinical Teacher, 27.02.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A randomised controlled trial of bag–valve–mask teaching techniques

AU - Strzelecki, Charlotte

AU - Shelton, Cliff L.

AU - Cunningham, Jennifer

AU - Dean, Charlotte

AU - Naz-Thomas, Sameera

AU - Stocking, Katie

AU - Dobson, Adam

PY - 2019/2/27

Y1 - 2019/2/27

N2 - SUMMARY Background: Bag–valve–mask (BVM) ventilation is a vital skill in the management of the collapsed patient; however, the quality of BVM ventilation is a cause for concern. Modified techniques, designed to be easier for the novice practitioner, offer an opportunity to improve quality. One such modification is the ‘LASOO’ (Lift, Apply, Slide, Oppose, Observe) approach, which offers theoretical benefits over the traditionally taught ‘CE’ (finger shapes) technique. We conducted a randomised controlled trial (RCT) to determine whether LASOO was superior to CE in terms of tidal volume, when taught to novices in the skills- lab setting. Methods: A total of 76 undergraduate health care students received a manikin- based teaching session on LASOO or CE. They then delivered 20 breaths (10 with each hand) to a modified airway manikin. The primary outcome was mean tidal volume; secondary outcomes were the proportion of breaths that achieved 150- mL and 400- mL threshold volumes. Subgroup analyses and statistical modelling were conducted for time-point, hand dominance and hand size. Results: The mean tidal volume was 320 mL for CE and 304 mL for LASOO. The median percentage of attempts that exceeded 150 mL was 85 for CE and 82.5 for LASOO. The median percentage of attempts that exceeded 400 mL was 20 for CE and 20 for LASOO. The differences recorded between the techniques were not statistically significant. There was a small, statistically significant increase in tidal volume across both techniques with time-point and holding the mask with the non- dominant hand. Discussion: LASOO is a viable alternative to CE. Educators may opt to teach either or both techniques, allowing students to choose the technique that they prefer.

AB - SUMMARY Background: Bag–valve–mask (BVM) ventilation is a vital skill in the management of the collapsed patient; however, the quality of BVM ventilation is a cause for concern. Modified techniques, designed to be easier for the novice practitioner, offer an opportunity to improve quality. One such modification is the ‘LASOO’ (Lift, Apply, Slide, Oppose, Observe) approach, which offers theoretical benefits over the traditionally taught ‘CE’ (finger shapes) technique. We conducted a randomised controlled trial (RCT) to determine whether LASOO was superior to CE in terms of tidal volume, when taught to novices in the skills- lab setting. Methods: A total of 76 undergraduate health care students received a manikin- based teaching session on LASOO or CE. They then delivered 20 breaths (10 with each hand) to a modified airway manikin. The primary outcome was mean tidal volume; secondary outcomes were the proportion of breaths that achieved 150- mL and 400- mL threshold volumes. Subgroup analyses and statistical modelling were conducted for time-point, hand dominance and hand size. Results: The mean tidal volume was 320 mL for CE and 304 mL for LASOO. The median percentage of attempts that exceeded 150 mL was 85 for CE and 82.5 for LASOO. The median percentage of attempts that exceeded 400 mL was 20 for CE and 20 for LASOO. The differences recorded between the techniques were not statistically significant. There was a small, statistically significant increase in tidal volume across both techniques with time-point and holding the mask with the non- dominant hand. Discussion: LASOO is a viable alternative to CE. Educators may opt to teach either or both techniques, allowing students to choose the technique that they prefer.

KW - A randomised controlled trial of bag–valve–mask teaching techniques

UR - https://doi.org/10.1111/tct.13008

U2 - 10.1111/tct.13008

DO - 10.1111/tct.13008

M3 - Article

JO - The Clinical Teacher

JF - The Clinical Teacher

SN - 1743-498x

ER -