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Preliminary Study
of a Ventilatory Pressure-Driven Device (Oxylator® EM-100)
in a Non-Paramedic EMS system
D. Lefrançois MD, A. Vadeboncoeur MD, P. Bayard
emt-instructor B.Sc.
Montérégie’s EMS System, Québec,
Canada
Abstract | System | Intervention
| Protocol with Mask
Ventilation
Protocol with Esophageal-Tracheal
Combitube | Qualitative
Assessment
Cardio-Respiratory Arrest Cases
| Non-Cardio-Respiratory Arrest
Cases | Conclusions
|
Abstract
Adequate ventilation has always been a problem in EMS, particularly
in non-paramedic systems; to evaluate a new technique based
on a pressure-driven apparatus (the Oxylator® EM-100), a
preliminary study was designed to assess quality of provided
ventilation, security and feasibility of the technique by EMT-D
level pre hospital providers.
The study was based on a standard approach to ventilatory support
for bradypneic (less than 8 breathings per minute) and arrest
patients. Actual system treatment protocols were used; pulse
oxymetry was measured as well as non-invasive blood pressure
(Welch-Allyn Life-Sign); procedures were recorded by the AED
and special reports were filled. Cases were studied by hospital
quality- assurance emergency physicians for results of blood
gas at arrival, complications, outcome, etc.
Six units were equipped with the device; between September 1997
and May 1998, 31 patients were ventilated using the Oxylator®
EM-100, most of them (26) being cardiorespiratory arrest (CRA)
cases and 4 non-arrest cases; 5 CRA cases were excluded (protocol-based
exclusion), and in one case the EMT decided to abort the protocol,
being incapable to obtain proper ventilation cycling. Use of
the device was associated with an increase of the initial measured
SaO2 (patient arrival in the ambulance); the device
worked very well for all patients except one; the EMTs found
it easy to use; it was not associated with complications such
as gastric distension or regurgitation, even in non-arrest cases.
Although further studies are planned, we estimate that the use
of the device in our EMS system is readily accepted by the EMTs,
that it seems promising regarding many aspects of ventilatory
support and that it does not appear to be associated with frequent
major complications. |
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