The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

EVALUATION OF FREE FLOW OXYGEN DEVICES FOR USE IN NON RESUSCITATION SITUATIONS

Kathleen Deakins, Nancy Johnson, Timothy Myers; University Hospitals Rainbow Babies & Children’s, Cleveland, OH

Background Free flow oxygen (FFO2) is often provided during resuscitation in the delivery room. The Neonatal Resuscitation Program (American Academy of Pediatrics Neonatal Resuscitation 5th Edition 2006:2-16-18) suggests that FFO2 be provided by oxygen mask, flow inflating bag or oxygen tubing from a cupped hand. FFO2 provided through a self inflating bag should be avoided. FFO2 is sometimes required in non-resuscitation situations. The purpose of this bench study was to identify the most effective methodology of delivering FFO2 within a target FiO2 range of 80-100% for non-resuscitation situations for infants compared to our current methodology. Methods: FiO2 was measured proximal to the mouth of a resuscitation mannequin by attaching a calibrated Maxtec oxygen sensor (Care Fusion: McGaw Park IL) near the mannequin’s mouth at 15 LPM using six free-flow oxygen methods and our standard methodology (control); (1) large bore tubing, universal adapters and oxygen tubing, (2) infant oxygen mask (Salter Medical, Arvin, CA #1114), (3) infant aerosol mask(Salter #1113), (4) resuscitation mask with oxygen tubing, (5) pressure line adapter with oxygen tubing capped on one end, and (6) Oxykid mask (Alberta, CAN) versus a self inflating CPR bag (Mercury Medical, Clearwater FLA). Five measurements (per position and device) were recorded as the mannequin was positioned on a flat plane with the head at a 45degree angle(facing midline) and head turned linear toward the free flow device positioned horizontally at 2 and 5 cm distances. FiO2 is displayed as mean values and standard deviations for both positions and distances and are displayed in the chart below. Results: The graph below displays the mean percentages of FiO2 at a 45 degree angle(purple) and turned linear toward the free flow device (yellow). Combining both positions and distances, the mean FiO2 of a self inflating bag measured 24 + 2% (Control), while the device that generated the highest mean FiO2 (#1 large bore tubing with adapter and oxygen tubing) of devices assessed measured 90 + 14%: closest to the target values. Conclusion: Optimal FiO2 should be delivered by a standard oxygen delivery device instead of a self-inflating bag. In certain non-resuscitation situations, free flow oxygen can be provided by a simple large bore tubing setup to achieve a temporary and higher concentration FiO2 if a flow-inflating resuscitation bag is not available. Sponsored Research - None