The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

EVALUATION OF TEN ADULT DISPOSABLE MANUAL RESUSCITATORS

Thomas A Barnes EdD RRT, Northeastern University--Boston, Massachusetts.

I evaluated the performance and safety of ten adult disposable manual resuscitators (DMRs): Adult Manual Resuscitator (Baxter), BagEasy (Respironics), CPR Bag (Mercury Medical), Capno-Flo (Kirk Specialty Systems), DMR (Puritan-Bennett), 1st Response (Sims), Pulmanex (Bird), Spur (Ambu), VCare (Ventlab), Vital Blue (Vital Signs). Method: I used standards and methods approved by American Society for Testing and Materials (F 920-85, ASTM Committee on Standards, Philadelphia 1985:1-22) and International Organization for Standardization (ISO 8382:1988[E] prepared by Technical Committee ISO/TC 121, Anaesthetic and Respiratory Equipment, ISO, New York, 1988:1-23). A Bio-Tek VT-1 Ventilator Tester was used as a lung model with C=0.02 L/cm H_2O [0.20 L/kPa] and R=20 cm H_2O.s.L^{-1} [2 kPa.s.L^{-1}].

Results: All of the DMRs met the ASTM and ISO standards for V_T (600 mL), f (20/min), and I:E ( < 1:2). The ASTM and ISO standards specify an FDO_2 of >= 0.85 with O_2 reservoir and O_2 flow of 15 L/min and V_E of 7.2 L/min (V_T 600 mL, f 12/min). When tested for FDO_2, the Vital Blue's mean (SD) was 0.69 (0.02), which was significantly lower (pɘ.001) than the other 9 DMRs which had an FDO_2>=0.94. When disabled with simulated vomitus, all DMRs were able to be restored to proper function within 20 seconds. All DMRs except the Vital Blue were functional at O_2 flow of 30 L/min. All DMRs passed tests for: forward and backward leakage, drop from 1 meter, and 10-second immersion-in-water. All DMRs except the CPR Bag were functional after storage at temperatures of -40ºC and 60ºC. The CPR Bag O_2 reservoir had three holes after storage at -40ºC. All DMRs passed tests for inspiratory and expiratory resistance ( <-5 cm H_2O andɝ cm H_2O respectively) with gas flow to the O_2 reservoir of 15 L/min. The mean (SD) expiratory resistance for Vital Blue was 38 (2) cm H_2O when gas flow to the O_2 reservoir was 30 L/min. The BagEasy was the only DMR tested which met the specifications for instruction/user manual. BagEasy, Baxter, Pulmanex were the only DMRs that prevented accidental disassembly. DMR (Puritan-Bennett) and VCare do not meet the FDO_2 requirement if their tube-type O_2 reservoir is in the collapsed storage position.

Conclusions: I conclude that BagEasy meets the ASTM and ISO standards for minimum performance and safety. The other DMRs tested were out of compliance with one or more of the ASTM and ISO requirements. I recommend that Vital Blue not be used when an FDO_2 of > 0.70 is needed or when oxygen flow can be set to 30 L/min.

OF-95-213

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