VORTRAN
®
Medical
5/26/2017
VORTRAN
®
GO
2
VENT™ User’s Guide
Page 23
Otto G. Raabe, Ph.D. and Mario Romano, RCP, Comparison of RespirTech PRO™ and Ambu
®
SPUR Resuscitators
During Simulated CPR.
BACKGROUND
: The cardiopulmonary resuscitation (CPR) guidelines and American Society for Testing and Materials
warn against the use of automatic pulmonary resuscitators during CPR closed chest compression because the compression
process may interfere with lung ventilation and airway resistance may prevent adequate ventilation. However, appropriately
designed pressure-cycled, pressure-controlled (rather than pressure-cycled, time-controlled) mechanical ventilators should be
able to automatically respond to pulmonary pressure changes to provide air or oxygen to the lung at high flow rate upon
demand and alert the rescuer of ventilatory problems. This evaluation was conducted to investigate ventilatory factors
associated with the use of either the portable RespirTech PRO™ (RTP) gas-powered automatic resuscitator or a typical
manually operated self-inflating bag-valve resuscitator.
METHODS
: Thirty tests, 17 with the RTP and 13 with the bag resuscitator, were conducted using the resuscitator connected
to a commercial test lung modified for automatic simulated chest-compression following standard compression rates as timed
with an electronic metronome. The test system was designed to be totally mechanical to avoid operator effects.
RESULTS
: Both resuscitators provided appropriate ventilation without excessive lung pressures following the chosen 5:1
compression-ventilation ratio. Overall, the RTP (at 25 L/min) and bag-valve resuscitator minute ventilation values were
about the same with means of 6.3±0.5 SE liters and 6.2±0.6 SE liters, respectively. The RTP automatically responded to
pulmonary pressure variations, rapidly delivering short breaths between compressions and a full inhalation during the pause
without serious pressure extremes. The highest observed intrapulmonary pressures (>80 cm H
2
O) occurred with the bag-
valve resuscitator operated during uninterrupted (“seamless”) chest compressions without inhalation synchronization.
DISCUSSION
: Both devices worked well following the standard protocol for CPR. Because the RTP inhalation-exhalation
cycling is visually and audibly obvious, indications of possible airway resistance or low tidal volume are readily observed by
the rescuer.
CONCLUSIONS
: The RTP may be used safely as an automatic resuscitator during CPR. Revision of CPR guidelines and
ASTM 920-93 for use of pressure-controlled resuscitators should be considered.
Michael Rossini, M.D., Barry Hickerson, EMT-P, Preliminary Evaluation of a Lightweight, Disposable Emergency
Transport Ventilator in the Aeromedical Setting
INTRODUCTION:
Recent evidence suggests patients receiving pre-hospital ventilation benefit from the use of emergency
transport ventilators (ETV). This evidence is supported by the fact manual ventilation using a bag-valve-mask type device
has substantial variations in rate and volume. These variations occur during initial treatment and transport even by well-
trained EMS crews. Proper tidal volume, airway pressures and respiratory rate are critical components of emergency
ventilatory support and variations can impact mortality and morbidity on a wide range of patients suffering from illness or
injury.
METHODS
: The purpose of the evaluation was to determine the practicality and ease of use of a new ETV, the “RespirTech
PRO” manufactured by VORTRAN Medical Technology 1, Inc. and identify any shortcomings during the initial phases of
patient treatment, transport and emergency room care. The ETV was placed into service on our single BK 117-B2 hospital-
based helicopter program. A Registered Nurse and Licensed Paramedic staff Air Med Team, which is based in Modesto,
California. The majority of scene transports are flown to our base hospital, Doctors Medical Center also in Modesto,
California. We gathered data on 12 patients from October 1999 to July 2000 that received ventilatory support from the ETV.
Vitals signs during and post transport, arterial blood gases post transport and subjective data regarding ease of use, set-up and
controls where gathered on all 12 patients.
RESULTS:
Twelve patients received on-scene and in-flight ventilatory support from the ETV without complications. All 12
adult patients were intubated by ground EMS personnel or the Air Med Team and placed on the ETV. The two manual
settings, pressure and rate were set without difficulty and facilitated by the use of continuous end-tidal CO2 monitoring. The
oxygen source for the ventilator was a 15-25 liter per minute fitting that allowed operation without difficulty in all 12 cases.
Blood gas analysis and review of vital signs during and post transport indicated all patients had been adequately ventilated
during initial treatment and transport.
CONCLUSION:
The RespirTech PRO proved to be an easy-to-use and reliable ETV that lends itself to a range of patients
requiring prehospital ventilation. Ventilation is a key factor in the outcome of many types of injury and illness and this ETV
should be considered for on-scene or transport use in a variety of prehospital settings.
