Open AccessEffect of a short training on neonatal face-mask ventilation performance in a low resource setting
Author(s) -
Alessandro Mazza,
Francesco Cavallin,
Anita Cappellari,
Antuan Divisic,
Ivana Grbin,
Jean Akakpo,
Abdou Razak Moukaïla,
Daniele Trevisanuto
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0186731
Subject(s) - medicine , leak , ventilation (architecture) , peak inspiratory pressure , anesthesia , respiratory system , tidal volume , mechanical engineering , environmental engineering , engineering
Background We assessed whether a short training, effective in a high resource country, was able to improve the quality of face-mask ventilation (FMV) in a low resource setting. Methods Local healthcare providers at the Centre Médico-Social, Kouvè, Togo were asked to ventilate a neonatal leak-free manikin before (time—t 1 ) and after (t 2 ) a two-minute training session. Immediately after this section, a further two-minute training with participants aware of the data monitor was offered. Finally, a third 1-minute FMV round (t 3 ) was performed by each participant. Ventilatory parameters were recorded using a computerized system. Primary outcome was the percentage of breaths with relevant mask leak (>25%). Secondary outcomes were percentages of breaths with a low peak inspiratory pressure (PIP<20 cm H 2 O), within the recommended PIP (20–35 cm H 2 O) and with a high PIP (>35 cm H 2 O). Results Twenty-six subjects participated in the study. The percentage of relevant mask leak significantly decreased (p<0.0001; β = -0.76, SE = 0.10) from 89.7% (SD 21.5%) at t 1 to 45.4% (SD 27.2%) at t 2 and to 18.3% (SD 20.1%) at t 3 . The percentage of breaths within the recommended PIP significantly increased (p<0.0001; β = +0.54, SE = 0.12). The percentage of breaths with PIP>35 cm H2O was 19.5% (SD 32.8%) at t 1 and 39.2% (SD 37.7%) at t 2 (padj = 0.27; β = +0.61, SE = 0.36) and significantly decreased (padj = 0.01; β = -1.61, SE = 0.55) to 6.0% (SD 15.4%) at t 3 . Conclusions A 2-minute training on FMV, effective in a high resource country, had a positive effect also in a low resource setting. FMV performance further improved after an extra 2-minute verbal recall plus real time feedback. Although the training was extended, it still does not cost much time and effort. Further studies are needed to establish if these basic skills are transferred in real patients and if they are maintained over time.