Ventilation skills of emergency medical technicians: A teaching challenge for emergency medicine.

We assessed the ability of 64 emergency medical technicians (EMTs) to ventilate a resuscitation manikin with a bag valve mask and with a pocket face mask to determine if their skill levels met the American Heart Association standard of 12 ventilations per minute, each with a tidal volume of 800 mL or more. All ventilation attempts were made during ongoing chest compressions (60 per minute). A successful ventilation was defined as a tidal volume of 800 mL +/- 40 mL. In a preliminary skills assessment, EMTs averaged 4.8 attempts with the bag valve mask and 2.9 attempts with the pocket face mask before a successful ventilation (P less than .01). In a formal skills assessment that lasted two minutes, successful ventilations per minute averaged 8.3 with the bag value mask and 9.9 with the pocket face mask (P less than 0.1). EMTs passed if they averaged ten or more successful ventilations per minute; 67% passed with the bag valve mask and 77% with the pocket face mask (NS). During a ten-minute extended skill assessment the EMTs averaged 9.6 ventilations per minute with the bag valve mask and 9.5 with the pocket face mask (NS). EMTs achieved initial success and maintained continued success better with the pocket face mask, but a reasonably high percentage (67%) met an objective standard when using the bag valve mask. We propose that objective standards be used to test the skills of EMTs for any ventilatory adjunct that they are permitted to use.