Discussion
PAD
Bag-Mask ventilation is one of the essential skills that every physician should know how to do it properly. Since there are several different ways to BMV, it is important to know the best way to do it that is both convenient and effective by single person. We introduced a method called hook method in which the resuscitator’s palm will be used on the front of the mask pad and his or her fingers will guide the patient’s chin upwards, And we compared this method with the E/C and T/E techniques which are common and valid. If the hook-method is successful, it can be a good alternative to do BMV.In a study done by Umesh et al. about comparing the E/O technique to the E/C technique, they concluded that the E-O technique is superior to the E-C technique in manikins during single person bag-mask ventilation performed by novices. experienced resuscitators, E/C provided a proper chest expansion. If one technique fails, another can be used instead [
Soleimanpour M et al., evaluated the quality of four different BVM ventilation techniques – E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (Nondominant hand), and Thenar Eminence (Nondominant hand)-E-C (Dominant hand) – among two novice and experienced groups. They concluded that Novices did Thenar Eminence (non-dominant hand) and E-C (dominant hand) technique better than the other two techniques. Therefore, for new trainees, these two techniques are recommended because of convenience [In another study, Soleimanpour M, et al., compared three techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O, and E-C. They stated that in professional operators there wasn’t any significant difference between these three methods, but in novices, the E/O technique is done better and it’s a good technique to teach to medical students [Osiński et al. showed a better success rate for a behind the head position in bag mask ventilation compared to ventilation from the side [
In present study, in pilot study on manikin using hook method, the succession rate was 93.7% and 6.3% were unsuccessful. In comparison of PCO2 results obtained from capnography between two E / C, T/E and hook techniques of patients, the success rate of ventilation in patients ventilated with E/C and T/E methods was 87.2% and 89.6% respectively, while in patients ventilated by hook method success rate was 93.9%. In fact, the success rate of ventilation with hook method is somewhat higher than the E / C and T/E methods and in comparing the success rate of ventilation between the three methods, a statistically significant difference was observed (p = 0.038).