Evaluation of 16 adult disposable manual resuscitators.

INTRODUCTION Disposable manual resuscitators are commonly used to ventilate patients during cardiopulmonary resuscitation, suctioning, and intrahospital transport, and their clinical performance is critical. METHODS We bench-tested 16 adult disposable manual resuscitators from 9 different manufacturers. We performed a series of tests and made observations using testing industry standards as a guideline. Each resuscitator was tested for fraction of delivered oxygen (FDO2), tidal volume delivery, drop test, and patient valve lock-up. We also made observations about reservoir style, ease or difficulty of attaching the positive end-expiratory pressure valve, size, texture, carbon dioxide detector, and if the resuscitator was labeled "latex free." RESULTS Reservoir style and manufacturer design significantly affected FDO2. In general, the resuscitators with reservoir bags provided better FDO2 than did the resuscitators with tubing reservoirs (large-bore or small-bore). Delivered tidal volumes were acceptable for all the resuscitators tested. All the resuscitators passed a standard drop test. None of the resuscitators had a patient valve lock up at high flow. With all but one resuscitator, attaching the positive end-expiratory pressure valve was easy and the valve attached securely. Most resuscitators were average in size and had good texture, but some were large, somewhat slippery, and difficult to handle. Only 2 resuscitators came with carbon dioxide detectors already attached. All but one of the resuscitators were labeled "latex free," and the one that was not was found not to contain latex proteins. CONCLUSIONS Resuscitator reservoir style and manufacturer design significantly affect FDO2. Some resuscitator models may not deliver adequate oxygen in certain clinical circumstances. Each institution should evaluate and choose the resuscitator that best fits its needs, while meeting established performance criteria.