Crossover assessment of intraoral and cuffed ventilation by emergency responders

Bernadette McCrory, Bethany R. Lowndes, Darcy L. Thompson, Michael C. Wadman, Matthew D. Sztajnkrycer, Richard Walker, Carol S. Lomneth, M. Susan Hallbeck

Research output: Contribution to journalArticlepeer-review


Objectives A cuffed bag valve mask (BVM) is the most common device used by emergency medical responders to ventilate patients. The BVM can be difficult for users to seal around the patient's mouth and nose. An intraoral mask (IOM) with snorkel-like design may facilitate quicker and better ventilation particularly under austere conditions. Methods Both a BVM and IOM were utilized by 27 trained emergency medical technicians and paramedics to ventilate a lightly embalmed cadaver. Ventilation efficacy, workload, and usability were assessed for both devices across four study conditions. Results The IOM was superior to the BVM in delivered tidal volume ratio (measure of leak, p < 0.03) and minute ventilation (p < 0.0001). Workload, ergonomic and usability assessments indicated that the IOM facilitated gripping through the reduced hand interface size (p < 0.01), decreased user effort (p < 0.001), and reduced upper limb workload (p = 0.0088). Conclusions In the assessed model, the IOM represented a better choice for airway management than the standard cuffed BVM. An emergency medical device that is intuitive, efficacious and less demanding has the potential to reduce responder stress and improve resuscitation efforts, especially during austere rescue and patient transport.

Original languageEnglish (US)
Pages (from-to)310-317
Number of pages8
JournalMilitary medicine
StatePublished - Mar 1 2019


  • EMT
  • paramedic
  • tidal volume
  • usability
  • workload

ASJC Scopus subject areas

  • General Medicine


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