Quality of bag-valve-mask ventilation in adults: a comparison of paramedic and nurse performance

INTRODUCTION: Oxygen delivery is an essential skill required for healthcare providers. The quality of ventilation affects patient survival. The purpose of this study was to analyze the quality of manual ventilation delivered with a bag-valve-mask (BVM) device by paramedics and nurses in relation to their clinical experience and self-assessment. MATERIAL AND METHODS: A prospective experimental comparative simulation study was designed. Two hundred healthcare workers were invited (100 paramedics and 100 nurses) to manage an adult respiratory arrest scenario and perform a 4-minute manual ventilation cycle. Ventilation parameters were assessed with SimMan 3G human patient simulator. Data on demographics, occupation, clinical experience, and self-assessment of conducted ventilation were collected through a questionnaire. RESULTS : Statistically significant differences in gender distribution across professions (p < 0.001), relationship between experience and occupation (p = 0.018), and frequency of ventilation within a year (p < 0.001) were observed. The median value for self-assessment in skills was 3 for nurses and 4 for paramedics. The average tidal volume in nurses was 394.6 mL and 390.1 mL in the paramedics group (p = 0.674). The mean ventilation rate was 10.4 bpm and 8.9 bpm respectively (p = 0.013). Only 4% of nurses and 1% of paramedics met the European Resuscitation Council (ERC) 2021 guidelines for manual ventilation. A statistically significant correlation was found between ventilation parameters and professional experience. More experienced providers tended to ventilate faster (R = 0.158, p = 0.025) and with a higher volume (R = 0.265, p < 0.001). CONCLUSIONS: Despite ventilations being performed by experienced personnel, ERC guidelines were met incidentally. It is recommended to pay more attention to BVM ventilation training even among experienced staff.