Enhanced Manual Ventilation with a Handheld Audiovisual Device - BENGI - Insights from a Pilot Study in Special Operations Medicine

Abstract

Background: In emergency casualty and evacuation situations, manual ventilation using self-inflating bags remains a critical skill; however, significant challenges exist in ensuring safety and effectiveness, since inaccurate manual ventilation is associated with life-threatening risks (e.g., gastric insufflation with aspiration, barotrauma, and reduced venous return).

Methods: This study assessed the impact of audiovisual feedback from the bag-valve-mask (BVM) emergency narration guided instrument (BENGI), a handheld manual ventilation guidance device, on improving performance and safety, immediately and 2 weeks after, with no additional manual ventilation training. In a crossover manikin simulation study with 20 participants, BENGI immediately and significantly improved tidal volume and respiratory rate accuracy.

Results: Intraand inter-participant variations were lower with BENGI, with Poincaré plot analysis showing improved performance that remained for at least 2 weeks following BENGI training.

Conclusion: BENGI's audiovisual feedback improves manual immediately and persistently, making it invaluable for training and clinical use in diverse scenarios, from battlespace to civilian emergencies.

Keywords: emergency; lung; monitoring; simulation; tidal volume; ventilator.