Comparison of tidal volumes obtained by one-handed and two-handed ventilation techniques

OBJECTIVES: To compare tidal volumes delivered by one- vs two-handed compressions of a manual resuscitation bag and assess the effects of subject characteristics on those tidal volumes. DESIGN: Subjects (108 healthcare providers from a 500-bed teaching hospital) were assigned randomly to one of two procedures: one- followed by two-handed compression or two- followed by one-handed compression. A 1-liter resuscitation bag, lung performance analyzer and Wright spirometer were used to measure tidal volume. Data collection occurred in a simulated situation. RESULTS: There was a significant difference in tidal volume delivered by one-handed (mean = 694 mL, SD = 111) vs two-handed compressions (mean = 827 mL, SD = 113). Hand size, grip strength, height and weight were correlated with tidal volumes generated by one-handed and two-handed procedures. No other subject characteristics were correlated with tidal volumes. CONCLUSIONS: Tidal volumes delivered by healthcare providers using one- vs two-handed compressions were found to be significantly different, with those delivered by two hands significantly greater than those delivered by one hand. Strength of hand grip was the best predictor of volume delivered and was more strongly correlated with volumes delivered by one rather than two hands.