An instructional video enhanced bag-mask ventilation quality during simulated newborn resuscitation

Aim: Approximately 20% of newborns infants need respiratory support at birth. This study evaluated whether video-based education could improve quality of positive pressure ventilation (PPV) performed by inexperienced staff during neonatal resuscitation. Methods: Fourth-year medical students were randomly paired and instructed to give PPV to a modified manikin as single-person resuscitators and as two-person-paired resuscitators using either an air cushion rim mask or a round mask before and after watching a self-instructional video. Airway pressure, gas flow, tidal volume and mask leak were recorded. PPV performance quality was analysed using video recording. Results: Mask leak was lower during one-person ventilation when using the air cushion rim mask (56 +/- 16%) compared to the round mask (71 +/- 19%). Round mask leak during one-person ventilation was significantly lower when using the two point top hold in contrast to the 'o.k.' rim hold (before training: 63 +/- 22% vs. 72 +/- 18%, after training: 57 +/- 17% vs. 77 +/- 12%). Watching a self-instructional video improved performance quality scores of both correct head positioning, and the quality of airway manoeuvres compared to baseline, however mask leak was not significantly reduced. Conclusion: A self-instructional video significantly improved bag mask PPV performance in inexperienced providers but did not improve mask leak in a model of neonatal resuscitation.