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 & Childrens, 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 mannequins 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
