WIP 55 - Applied forces and measured fatigue with varying mask hold during simulated neonatal face-mask positive pressure ventilation

Poster Number: WIP 55
Publication Number: WIP 55.2594

Background: Neonatal positive pressure ventilation (PPV) with a face mask requires an applied force to seal the mask against a newborn’s face. Care must be taken when holding the face mask, as inadequate force leads to high leak, while excess force may obstruct the airway and cause injury. Previous work has characterized applied forces on a manikin’s face and under the head with different PPV devices and masks while using the same mask hold. This study expands upon these results by comparing applied forces and fatigue when administering PPV with a one-hand hold and a two-hand hold. Understanding how mask hold affects applied forces and fatigue may improve training and inform PPV strategy recommendations.

Objective: (1) Assess differences in applied forces between a one-hand mask hold and a two-hand mask hold, (2) determine any differences in fatigue between different mask holds.

Design/Methods: Experienced neonatal healthcare providers performed simulated face mask PPV on a high-fidelity SimNewB manikin (Laerdal), with force sensors positioned on the manikin’s face and under the head. Each participant completed three 2-minute trials of simulated PPV with three device-mask hold combinations while wearing surface electromyography (EMG) sensors on their forearms. The three conditions were: a one-hand C-E hold with a self-inflating bag (Medline), a one-hand C-E hold with a T-piece resuscitator (NeoPuff), and a two-hand hold with a T-piece resuscitator. Each condition was completed with a neonate anatomic inflated-rim mask (Ambu). After each trial, participants answered a survey about their perceived fatigue. Applied forces will be analyzed using pairwise t-tests between conditions, and force symmetry will be assessed using a root mean square difference (RMSD) of the face force sensors. EMG sensor data and fatigue survey results will be assessed for each condition and presented as summary statistics. Data collection will be completed in December, and analyses will be completed in January. This study was approved by the University of Michigan Internal Review Board (HUM #00236465).