Newborn face mask ventilation training using a standardised intervention and respiratory function monitor: a before and after manikin study.

Abstract

Objective: The International Liaison Committee on Resuscitation has recommended improvements in training for neonatal resuscitation, highlighting the potential role of respiratory function monitors (RFMs). Our objective was to determine whether a manikin-based, standardised face mask ventilation training intervention using an RFM with a simple visual display reduced face mask leak.

Design: Multicentre, before and after study. Participants and instructors were blinded to the RFM display during both assessment periods.

Participants: Healthcare professionals working or training in a hospital providing maternity and neonatal services.

Intervention: All participants underwent a training intervention on positive pressure ventilation using a modified, leak-free manikin and RFM. The intervention consisted of a demonstration of optimal face mask ventilation technique, training in RFM interpretation with corrective strategies for common scenarios and a period of deliberate practice. Each participant performed 30 s of positive pressure ventilation blinded to the RFM display before and after training.

Main outcome measures: The primary outcome was face mask leak (%) measured after training. Secondary outcome measures included expired tidal volume, inflating pressures and ventilation rate. Adjustments made to technique during training were an important qualitative outcome.

Results: Four hundred and fourteen participants were recruited over a 13-month period from April 2022, and 412 underwent analysis. Median (IQR) face mask leak before training was 31% (10-69%) compared with 10% (6-18%) after training (p<0.0001). Improvements were noted across all other ventilation parameters.

Conclusion: Standardised face mask ventilation training using an RFM with simple visual feedback led to a significant reduction in leak.