AN EVALUATION OF THE PHYSICAL AND FUNCTIONAL-CHARACTERISTICS OF RESUSCITATORS FOR USE IN PEDIATRICS

Objective: To evaluate the physical and functional characteristics of pediatric self-inflating resuscitators. Design: Tested under simulated clinical conditions. Results were analyzed by descriptive analysis. Setting: A pulmonary laboratory in a university hospital. Methods: Eight new pediatric self-inflating resuscitators were obtained from the manufacturers and evaluated for functional characteristics including: a) fraction of delivered oxygen at 10 L/min and a tidal volume of 300 mL; b) maximum stroke volume against no resistance; and c) maximum cycling frequency at -5-degrees-C, 20-degrees-C, and 48-degrees-C. The resuscitators were also evaluated for physical characteristics, including potential for misassembly, pressure relief valves, expiratory valve leak, and inspiratory resistance. Results: All resuscitators met the minimum standards of the Canadian Standards Association and American Standards for Testing of Materials. However, one bag cycled at only 32 breaths/min at - 5-degrees-C, marginally within accepted standards. Only five self-inflating resuscitators had pop-off valves. These valves malfunctioned, with valve activation occurring well above the accepted standards. Three of the self-inflating resuscitators could be misassembled for use. Four of the resuscitators were unable to deliver tidal volumes required for preoxygenation in a 20-kg child. Conclusions: While these self-inflating resuscitators met the minimum standards, they are all unable to deliver 100% oxygen. One unit is probably not appropriate in the out-of-hospital setting when ambient temperatures are < 0-degrees-C. Those resuscitators that can be misassembled are dangerous in unskilled hands. In addition, reliance on pop-off valve activation to limit airway pressure is dangerous.