Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask

Annals of Emergency Medicine
Brian E DriverMatthew E Prekker

Abstract

Nonrebreather masks and bag-valve masks are used for preoxygenation before emergency intubation. Flush rate oxygen delivered with a nonrebreather mask is noninferior to bag-valve mask oxygen at 15 L/min. We seek to compare the nonrebreather mask with flush rate oxygen to a bag-valve mask with flush rate oxygen (with and without inspiratory assistance) and determine whether the efficacy of bag-valve mask with flush rate oxygen is compromised by a simulated mask leak. We conducted 2 prospective studies in healthy, adult volunteers. All devices in both studies used flush rate oxygen, achieved by rotating the flowmeter dial counterclockwise until it could not be rotated farther, which delivered oxygen at 40 to 60 L/min. Study 1 compared preoxygenation with nonrebreather mask to bag-valve mask (modified with a one-way exhalation port) with and without a simulated mask leak. Study 2 compared nonrebreather mask to bag-valve mask with inspiratory assistance. The primary outcome was FeO2. For each comparison, we prespecified a noninferiority margin of FeO2 for the nonrebreather mask (compared with the bag-valve mask, bag-valve mask with mask leak, and bag-valve mask with assistance) of 10%. Thirty subjects were enrolled in study 1 and 2...Continue Reading

Citations

Jan 3, 2020·American Journal of Respiratory and Critical Care Medicine·Jarrod M MosierPeter G Brindley
Oct 17, 2020·Anesthesia and Analgesia·Rebecca L KornasUNKNOWN Society for Airway Management’s Special Projects Committee
Feb 3, 2021·The Journal of Emergency Medicine·Susan R Wilcox, Anna Condella
Nov 5, 2020·Journal of the American College of Emergency Physicians Open·Matthew OliverJohn C Sakles
Jun 16, 2021·Anesthesia and Analgesia·Rebecca L KornasJarrod M Mosier
Jan 11, 2022·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Robert F ReardonBrian Driver

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