Assessment of Preoxygenation Strategies in the Prehospital Environment

Queen Mary University of London

Status: Completed

Conditions: Hypoxia; Anesthesia

Treatments: Device: Bag-Valve-Mask (BVM); Device: Continuous Positive Airway Pressure (CPAP); Device: Non-rebreather Mask (NRM)

Study type: Interventional

Funder types: Other

Identifiers

NCT02694705

QMERC2015/69

Details and patient eligibility

About

Comparison of the preoxygenation efficacy of tidal volume breathing using three different preoxygenation techniques which are available to providers in the prehospital environment.

Full description

Prospective randomised interventional study.

Healthy volunteers will be positioned supine and undergo preoxygenation by tidal volume breathing for 3 minutes using each technique in turn. The sequence of techniques for each volunteer will be randomised in advance. Investigators will be instructed to ensure a good mask seal throughout the testing period. At the end of a 3 minute preoxygenation period, after a brief breath hold, the volunteer will exhale into reservoir tubing, allowing the fractional expired oxygen concentration (FeO2) to be determined (primary outcome) using a calibrated gas analyser.

The techniques being assessed have been chosen from methods of preoxygenation commonly available to clinicians in the prehospital environment:

Continuous Positive Airway Pressure mode with fractional inspired oxygen concentration (FiO2) 100% using a portable ventilator. Bag-valve-mask device (BVM) with 15 l/min oxygen flow. Non-rebreather mask (NRM) device with 15 l/min oxygen flow.

Volunteers will also be asked to indicate the subjective ease of breathing for each technique (secondary outcome) using a visual analogue scale (VAS).

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adult volunteers

Exclusion criteria

• Pregnancy
• Respiratory disease
• Bearded
• Facial abnormality
• Edentulous

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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30 participants in 3 patient groups

CPAP

Experimental group

Description:

3 minutes of preoxygenation with a portable ventilator providing Continuous Positive Airway Pressure (CPAP) at 5 cmH20 and an FiO2 of 100%.

Treatment:

Device: Continuous Positive Airway Pressure (CPAP)

BVM

Experimental group

Description:

3 minutes of preoxygenation with a bag-valve-mask (BVM) device and oxygen flow rate of 15 litres / minute.

Treatment:

Device: Bag-Valve-Mask (BVM)

NRM

Experimental group

Description:

3 minutes of preoxygenation with a non-rebreather mask (NRM) device and oxygen flow rate of 15 litres / minute.

Treatment:

Device: Non-rebreather Mask (NRM)