Ambu SmartMan© is the first product to give you real-time feedback as you practice performing ventilations.
The research shows that we need to improve how we give ventilations. We tend to provide inspirations too quickly and give too many ventilations, inadvertently giving too many and too quickly.
With SmartMan's INTELLIGENT Manikin Solution, you will see how to improve your performance.
Both the rate and volume of inspiration as well as the rate at which you perform ventilations are displayed in real time in easy to understand colorful bar graphs. Thus you see the color bar and immediately know what you have to change to improve. For more information on how SmartMan works, download the document, "The Only Way to Perfect Ventilations".
Ventilations
Regardless of when you perform ventilations, they are an important part of CPR. They can be performed through mouth-to-mouth, use of a bag valve mask (BVM), or with a regulator. Even if an oral pharyngeal airway (OPA) or a nasal pharyngeal airway (NPA) has been inserted, the skill required to provide the correct amount of air with the correct pressure at the correct interval remains the same. For more detail on how to correctly perform ventilations, or you can download this document, "Getting Ventilations Right".
SmartMan now has a way for you to practice an advanced airway and for you to practice ventilating when the device is in place. See below for more details.
VENTILATIONS IN 30:2 CPR: There are several key aspects to getting these right. Inspiration tends to be too fast. It should take a full second to deliver the 500ml - 700ml as set in the new guidelines 2010. During CPR the second breath must begin as soon as the first breath has fully expired. Ventilations are an important part of CPR and must be learned correctly.
VENTILATIONS IN RESCUE BREATHING: In rescue breathing, it should take a full second to deliver the 500ml - 700ml as set out in the guidelines. Then there should be a wait before the start of the next ventilation. National averages show that the tendency is to put in too much airway too often. Ventilations are performed in many different circumstances both in-hospital and out of hospital.
VENTILATIONS WITH JAW THRUST: The jaw thrust is used to open the airway if you suspect a cervical spine
injury such as when there is a collapse with a head injury, or from diving
into shallow water.
SmartMan gives you real time feedback as you ventilate with the Jaw
Thrust. If it has been performed correctly then ventilations can be
performed easily with adequate volumes. If the airway is not open
there will be resistance and low or no volume will go into the lungs. For more information on jaw thrust watch the video, "Correct Jaw Thrust Maneuver".
VENTILATIONS WITH AN OPA: Ambu Airway SmartMan has an anatomically correct tongue, trachea and esophagus. It is possible to place an OPA and perform ventilations when it has been placed.
VENTILATIONS WITH AN ADVANCED AIRWAY: Ventilations with an advanced airway are timed to begin on the release of chest. The Ambu Airway SmartMan creates the natural negative pressure which occurs in a real chest so that it measures whether you have achieved the 500ml - 700 ml in the 0.3 a second required in this skill. SmartMan gives you the real time feedback to help you master an advanced airway.
RAPID SKILLS IMPROVEMENT: Even though performing ventilations is more difficult than performing compressions, if you have the right training tool it can be accomplished to a high level of competence in a very short time. Independent research has
shown that with just minutes of practice on SmartMan, EMTs and paramedics improved their
performance substantially. Correct duration of inspiration increased from 34% to 80%, and
volume of inspiration and ventilation rate improved from 63% to 93%.
For more information download this SmartMan Announcement.
Review of Key Features
All Ventilations, be they part of CPR or rescue breaths, share the same rate of inspiration and volume of air delivered. They differ in the number delivered and the interval between the ventilations.
Rate of inspiration: the target is to deliver air at a constant rate into the lung for about 1 second
Volume of inspiration: the target is about 0.5l (half of a liter)
Rate of expiration: release the bag immediately the 0.5l has been delivered so the air can expire quickly.
Time between each ventilation: the interval between ventilations depends on
whether it is performed
a) as a part of 30:2 CPR, or
b) during rescue breathing
Interval In CPR 30:2
Time between each ventilation, the interval between ventilations depends on
whether it is performed in CPR or in Rescue Breathing.
During the 30:2 cycle of CPR there is NO TIME BETWEEN each ventilation. As soon the breath has fully expired, begin the next one. In CPR you provide 2 breaths within 4 seconds. (1 sec in, 1 sec out, 1 sec in, 1 sec out, then start or recommence compressions).
Interval In Rescue Breathing
The rate for performing ventilations depends on whether it is done by a lay rescuer or by someone who has a duty to act. For the former the rate is specified as 8 to 10 per minute and for the latter it is 10 to 12 per minute.
Taking the middle number which is shared makes it easy to work it out.
The time from the start of 1 inspiration to the start of the next inspiration is about 6 seconds. (1 sec in, 1 sec out, 4 second wait, then start the next ventilation).
Ventilations on SmartMan
At the Main Menu select "Ventilations" then the option which you want. On SmartMan there are two different ways to PRACTICE performing ventilations; for rescue breathing and for CPR.
Rescue Breathing PRACTICE
You perform 1 minute of ventilations at a rate of 10-12 per minute. You should be taking 1 second to inspire to 0.5 to 0.6 liters, then fully release the bag, wait for 4 seconds and repeat.
Rescue Breathing TEST
You perform 1 minute of ventilations at a rate of 10-12 per minute. You should be taking 1 second to inspire to 0.5 to 0.6 liters, then fully release the bag, wait for 4 seconds and repeat.
CPR Ventilations PRACTICE
During CPR you only get 4 seconds to give the 2 ventilations. In the SmartMan ventilations for CPR practice, we provide you with a practice of 20 breaths. You perform 20 breaths one after the other so you can get a feel for slowing the rate of inspiration but moving quickly to the next ventilation. NOTE: In SmartMan this is a training exercise ONLY. In the 30:2 cycle of CPR you only ever perform 2 ventilations.
To specifically practice the correct interval between ventilations, you need to choose either the practice for Rescue Breathing or the practice for CPR Ventilations Practice.
If you are only concentrating on practicing the correct rate of inspiration and volume of inspiration, then you can use either section.
What you see on the Screen
On SmartMan you see the colored bars as you perform either type of ventilation. Again your target is the bright green. If you perform correct inspiration at the correct volume with the correct interval between each ventilation both the vertical bars and the horizontal bars will be bright green.
With ventilations, once you complete the set, the computer will display 2 rows of numbers above each bar on the graph. The top row (the number is right above the vertical bar) is the exact time of the inspiration (your target is 1 second) and the bottom row (the number is right above the horizontal bar) is the exact time from the start of one ventilation to the start of the next ventilation (your target in rescue breathing is 6 seconds).
How To Squeeze the BVM (the bag)
The target performance for a ventilation with a BVM is to have a smooth consistent squeeze of the bag for about 1 second. Then immediately release your hand from the bag. It is slow on the squeeze then immediately fully release.
It is a common error to hold the bag once it has been squeezed to the target 0.5 – 0.6 liter delivery point.
During the instruction phase for performing ventilations in CPR (NOT IN RESUCE BREATHING), when students are told to go slow, this must be made clear that going slow means going slow for the inspiration. Inspiration should take a second. When performing the 2 ventilations in CPR, it is not slow between compressions. In CPR the second ventilation must start as soon as the air has fully emptied from the lungs.
SmartMan is a private company creating training systems to improve survival rates. We also provide consultation and guidance on implementing system wide solutions.
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