Tools for accurate tidal volume calculation during out-of-hospital ventilation

Background: Out-of-hospital cardiac arrest in England affects approximately 60 000 individuals annually, with only 8% surviving to discharge. Accurate tidal volume calculation, based on predicted body weight, is essential to avoid hyperventilation and its associated risks. Aims: This systematic literature review aims to evaluate tools, which estimate height or weight in adults, to determine their suitability for use within prehospital settings, enabling accurate tidal volume calculation. Methods: A systematic literature review was conducted using MEDLINE and CINAHL databases to identify relevant studies on height and weight estimation tools. The review adhered to PRISMA guidelines and assessed study quality using a modified Newcastle-Ottawa Scale. Findings: In the prehospital care setting, three tools – ulna length, tidal tape, and the Modified PAWPER XL-MAC-2 – demonstrated good accuracy for weight estimation, with the Modified PAWPER XL-MAC-2 tool identified as the most likely to yield accurate results given the specific circumstances of prehospital care. Conclusion: Accurate height and weight estimation tools are essential for calculating tidal volumes in the management of out-of-hospital cardiac arrest. While the Modified PAWPER XL-MAC-2 appears effective, further research is needed to confirm its efficacy and practicality in prehospital settings.