Continuous flow insufflation of oxygen compared with manual ventilation during out-of-hospital cardiac arrest: A survey of the paramedics

Mathieu Groulx; Alexandra Nadeau; Marcel Émond; Jessica Harrisson; Pierre-Gilles Blanchard; Douglas Eramian; Eric Mercier

doi:10.1177/20503121211018105

Continuous flow insufflation of oxygen compared with manual ventilation during out-of-hospital cardiac arrest: A survey of the paramedics

SAGE Open Med. 2021 Jun 30:9:20503121211018105. doi: 10.1177/20503121211018105. eCollection 2021.

Authors

Mathieu Groulx^{1

2}, Alexandra Nadeau^{1

3}, Marcel Émond^{1

2

3

4}, Jessica Harrisson⁵, Pierre-Gilles Blanchard^{1

2}, Douglas Eramian^{4

5}, Eric Mercier^{1

2

3

4

5}

Affiliations

¹ Centre de recherche du CHU de Québec, Université Laval, Québec, QC, Canada.
² Faculté de médecine, Université Laval, Québec, QC, Canada.
³ Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL-UL), Québec, QC, Canada.
⁴ Département de médecine d'urgence, CHU de Québec, Québec, QC, Canada.
⁵ Direction des services préhospitaliers d'urgence, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de la Capitale-Nationale, Québec, QC, Canada.

Abstract

Introduction: In 2018, a continuous flow insufflation of oxygen (CFIO) device (b-card™, Vygon (USA)) placed on a supraglottic airway (SGA) became the standard of care to ventilate patients during adult out-of-hospital cardiac arrest (OHCA) care in Quebec-Capitale-Nationale region, Canada. This study aims to assess the paramedics' perception as well as the disadvantages and the benefits relative to the use of CFIO during OHCA management.

Methods: An invitation to complete an online survey (Survey Monkey™) was sent to all 560 paramedics who are working in our region. The survey included 22 questions of which 9 aimed to compare the traditional manual ventilation with a bag to the CFIO using a 5-point Likert-type scale.

Results: A total of 244 paramedics completed the survey, of which 189 (77.5%) had used the CFIO device during an OHCA at least once. Most respondents felt that the intervention was faster (70.2%) and easier (86.5%) with the CFIO device compared with manual ventilation. CFIO was also associated with perceived increased patient safety (64.4%) as well as paramedic safety during the evacuation (88.9%) and the ambulance transport (88.9%). Paramedics reported that physical (48.1%) and cognitive (52.9%) fatigue were also improved with CFIO. The main reported barriers were the bending of the external SGA tube and the loss of capnography values.

Conclusion: The use of CFIO during adult OHCA care allows a simplified approach and was perceived as safer for the patient and the paramedics compared with manual ventilation. Its impact on patient-centred outcomes needs to be assessed.

Keywords: Continuous flow insufflation; airway management; cardiac arrest; health care survey; paramedics.