Reassessing hyperventilation in prehospital care as a function of hand size
Maniraj Jeyaraju, Ali Aledhaim, Thomas Grissom, Jon Mark Hirshon.
Abstract
Background: Approximately 356,000 out-of-hospital cardiac arrests occur yearly (AHA, 2019), and prehospital providers must rely on their training to successfully resuscitate these patients. Despite advancements in their training, providers tend to hyperventilate patients, which has been linked to adverse health sequelae. While studies have briefly explored provider hand size as a variable, none have conclusively connected hand size and hyperventilation rates. Furthermore, minute ventilation (MV) has not been explored as a parameter of ventilation performance.
Methods: A focused revisit of this relationship between hand size and ventilation performance through manikin simulation testing of 122 emergency medical services professionals in Maryland evaluated the ventilator parameters of breath rate (BR), tidal volume (TV), and MV.
Results: The cohort’s hyperventilation rate was 29%. In this study, evidence approaching statistical significance exists that participants with small hands (as determined by glove size) provide greater MV than other participants, yet no size-specific relationship was found for BR or TV. Further stratifying the participant certification level, the basic life support-certified providers with small hand sizes provided significantly greater BR administration.
Conclusion: These findings affirm that hyperventilation is still a concern, MV is an important ventilator parameter to include in future studies, and a larger scale study is needed.
Key words: ventilation; cardiac arrest; prehospital emergency care
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