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Simulation-based Evaluation of an Ergonomically Designed
                                            Face Mask among Novice Users
                                      1
                                          Bauman EB, 1Joffe AM, 2 Devries SA, 2 Lenz L, 1Hetzel SJ, 1Seider SP, 1Han S
                                      1
                                          University of Wisconsin School of Medicine and Public Health, Madison, WI
                                                           2
                                                             Wester n Technical College, LaCrosse WI

INTRODUCTION
The ErgoMaskTM is a new facemask designed                                                                                  •Overall, tidal volumes were significantly
to ergonomically fit the clinicians’ left hand.                                                                             higher at all time points using the ErgoMaskTM
The dome of the ErgoMaskTM contains                                                                                        compared to the standard mask.
grooves and edges enabling the operator to
use an asymmetrical left-hand grip, with the
posterior part of the mask higher than the                                                                                 •Over time, ventilation via the ErgoMaskTM
anterior. This design should better enable full                                                                            did not significantly decrease (0.13 Ml/breath)
contact between the operator’s hand and the                                                                                whereas use of the standard mask resulted in a
mask, avoid hand fatigue, allowing for better                                                                              linear decrease in ventilation by 10 ml/breath
                                                                          Special Thanks Lenora Parr                       (p < 0.001).
control of the facemask. We hypothesized
that ventilation with the ErgoMaskTM would                After a brief tutorial on each mask, participants
result in greater delivered tidal breaths as              performed basic airway maneuvers on the
compared to a standard facemask.                          airway trainer and obtained a mask seal prior                    •This decay in ventilation over time was                           Figure 1: Summary of repeated measures ANOVA with fitted regression lines: Y = tidal volume; X =

                                                          to the first ventilator-delivered breath. The                     unaffected by gender. However, males                                 number of breaths; Dots represent ErgoMaskTM; Triangles represent Standard mask; Red repre-

                                                          returned tidal volume was recorded for each of                   performed better in terms of tidal volume                            sent Males; Black represents Females.

                                                          12 breaths for each participant for each mask.                   than females at all time points regardless of
                                                          Differences in minute ventilation between                        mask type used.                                                    Table 1: Mean (sd) tidal volume (mL) by Breath and Mask Type
                                                          masks were assessed by paired student T-Test
                                                          with a significance defined by a p-value of                        CONCLUSIONS                                                        Breath*        Standard Mask                   ErgoMask                        p-value**
                                                          <0.05.                                                           Novice airway managers were able to more                             1            330.3 (124.8)                   376.9 (98.6)                    0.682
                                                                                                                           effectively ventilate via a facemask by
                                                                                                                                                                                                2            316.5 (136.4)                   369.0 (104.1)                   0.594
                                                          Any effect on the ability to ventilate over time                 using an ergonomically designed device, the
                                                          with each mask was assessed by a repeated                        ErgoMaskTM, compared with a traditional                              3            304.2 (141.9)                   364.1 (105.7)                   0.369
                                                          measure analysis of variance (RM-ANOVA)                          standard mask. Further, performance did
                                                          with tidal volume set as the response variable                   not decay over time when subjects were                               4            264.1 (163.2)                   361.0 (123.8)                   0.040
                                                          and mask type, number of breaths, and gender                     using the ErgoMaskTM, whereas significant
METHODS                                                   as dependent variables with significance                          decay did occur with the standard mask.                              5            261.3 (154.7)                   371.9 (114.3)                   0.011

Allied health students with minimal airway                defined as a p-value <0.05.                                       Insofar as BVM is likely to be necessary                             6            260.1 (160.5)                   369.8 (105.7)                   0.023
management training used a standard or                                                                                     for more than the 1-minute tested here in
ErgoMaskTM to ventilate a Laerdal®Airway                                                                                   actual clinical resuscitation scenarios, using                       7            256.8 (151.7)                   363.3 (122.4)                   0.049
Management Trainer in a random, crossover                                                                                  the ErgoMaskTM may have an even greater
design using their left hands. A Pulmonetics              RESULTS                                                          impact than what we have shown. Clinical                             8            243.7 (165.7)                   369.6 (118.2)                   0.005

LTV®1200 volume-cycled ventilator set to                  The following results are based on an RM-                        correlation and further examination of gender
                                                                                                                                                                                                9            234.4 (169.6)                   368.0 (107.7)                   0.005
deliver a tidal volume of 500 mL, 12 times                ANOVA analysis with the following dependent                      differences is needed.
per minute, at an inspiratory-to-expiratory               variables: mask type, time, gender, and the                                                                                           10           218.4 (164.3)                   364.6 (114.4)                   0.003
ratio of 1:4 (cycle-length 5 seconds) provided            interaction between mask type: time and                          Contact Person:
the actual ventilation. Participants squeezed             mask type: gender.                                               Eric B. Bauman, PhD, RN
                                                                                                                                                                                                11           223.3 (167.9)                   370.2 (114.0)                   < 0.001
a breathing bag with their right hand in time                                                                              Department of Anesthesiology
                                                                                                                                                                                                12           216.4 (170.3)                   370.1 (118.8)                   0.001
with the ventilator-delivered breath to simulate                                                                           University of Wisconsin School of Medicine and Public Health
actual bag-valve-mask (BVM) ventilation.                  •Minute ventilation was significantly greater                     600 Highland Avenue                                                * Breaths were taken successively every 5 seconds
                                                          with the ErgoMaskTM than the standard                            Madison, WI 53792

                                                          mask.                                                            ebauman@wisc.edu                                                   ** paired T-Tests and are Bonferroni adjusted for 12 comparisons



                     This project was supported in part by the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), funded through an NIH Clinical and Translational Science Award (CTSA),

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Bauman et al ErgoMask Poster 2010

  • 1. Simulation-based Evaluation of an Ergonomically Designed Face Mask among Novice Users 1 Bauman EB, 1Joffe AM, 2 Devries SA, 2 Lenz L, 1Hetzel SJ, 1Seider SP, 1Han S 1 University of Wisconsin School of Medicine and Public Health, Madison, WI 2 Wester n Technical College, LaCrosse WI INTRODUCTION The ErgoMaskTM is a new facemask designed •Overall, tidal volumes were significantly to ergonomically fit the clinicians’ left hand. higher at all time points using the ErgoMaskTM The dome of the ErgoMaskTM contains compared to the standard mask. grooves and edges enabling the operator to use an asymmetrical left-hand grip, with the posterior part of the mask higher than the •Over time, ventilation via the ErgoMaskTM anterior. This design should better enable full did not significantly decrease (0.13 Ml/breath) contact between the operator’s hand and the whereas use of the standard mask resulted in a mask, avoid hand fatigue, allowing for better linear decrease in ventilation by 10 ml/breath Special Thanks Lenora Parr (p < 0.001). control of the facemask. We hypothesized that ventilation with the ErgoMaskTM would After a brief tutorial on each mask, participants result in greater delivered tidal breaths as performed basic airway maneuvers on the compared to a standard facemask. airway trainer and obtained a mask seal prior •This decay in ventilation over time was Figure 1: Summary of repeated measures ANOVA with fitted regression lines: Y = tidal volume; X = to the first ventilator-delivered breath. The unaffected by gender. However, males number of breaths; Dots represent ErgoMaskTM; Triangles represent Standard mask; Red repre- returned tidal volume was recorded for each of performed better in terms of tidal volume sent Males; Black represents Females. 12 breaths for each participant for each mask. than females at all time points regardless of Differences in minute ventilation between mask type used. Table 1: Mean (sd) tidal volume (mL) by Breath and Mask Type masks were assessed by paired student T-Test with a significance defined by a p-value of CONCLUSIONS Breath* Standard Mask ErgoMask p-value** <0.05. Novice airway managers were able to more 1 330.3 (124.8) 376.9 (98.6) 0.682 effectively ventilate via a facemask by 2 316.5 (136.4) 369.0 (104.1) 0.594 Any effect on the ability to ventilate over time using an ergonomically designed device, the with each mask was assessed by a repeated ErgoMaskTM, compared with a traditional 3 304.2 (141.9) 364.1 (105.7) 0.369 measure analysis of variance (RM-ANOVA) standard mask. Further, performance did with tidal volume set as the response variable not decay over time when subjects were 4 264.1 (163.2) 361.0 (123.8) 0.040 and mask type, number of breaths, and gender using the ErgoMaskTM, whereas significant METHODS as dependent variables with significance decay did occur with the standard mask. 5 261.3 (154.7) 371.9 (114.3) 0.011 Allied health students with minimal airway defined as a p-value <0.05. Insofar as BVM is likely to be necessary 6 260.1 (160.5) 369.8 (105.7) 0.023 management training used a standard or for more than the 1-minute tested here in ErgoMaskTM to ventilate a Laerdal®Airway actual clinical resuscitation scenarios, using 7 256.8 (151.7) 363.3 (122.4) 0.049 Management Trainer in a random, crossover the ErgoMaskTM may have an even greater design using their left hands. A Pulmonetics RESULTS impact than what we have shown. Clinical 8 243.7 (165.7) 369.6 (118.2) 0.005 LTV®1200 volume-cycled ventilator set to The following results are based on an RM- correlation and further examination of gender 9 234.4 (169.6) 368.0 (107.7) 0.005 deliver a tidal volume of 500 mL, 12 times ANOVA analysis with the following dependent differences is needed. per minute, at an inspiratory-to-expiratory variables: mask type, time, gender, and the 10 218.4 (164.3) 364.6 (114.4) 0.003 ratio of 1:4 (cycle-length 5 seconds) provided interaction between mask type: time and Contact Person: the actual ventilation. Participants squeezed mask type: gender. Eric B. Bauman, PhD, RN 11 223.3 (167.9) 370.2 (114.0) < 0.001 a breathing bag with their right hand in time Department of Anesthesiology 12 216.4 (170.3) 370.1 (118.8) 0.001 with the ventilator-delivered breath to simulate University of Wisconsin School of Medicine and Public Health actual bag-valve-mask (BVM) ventilation. •Minute ventilation was significantly greater 600 Highland Avenue * Breaths were taken successively every 5 seconds with the ErgoMaskTM than the standard Madison, WI 53792 mask. ebauman@wisc.edu ** paired T-Tests and are Bonferroni adjusted for 12 comparisons This project was supported in part by the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), funded through an NIH Clinical and Translational Science Award (CTSA),