Abstract
Objective To determine the frequency of provision and main providers (veterinary surgeons, nurses or trainees) of manual ventilation in UK veterinary practices. Furthermore, to determine the variation in peak inspiratory (inflation) pressure (PIP), applied to a lung model during manual ventilation, by three different groups of operators (inexperienced, experienced and specialist), before and after training. Study Design Questionnaire survey. Development of a lung model simulator with real-time biometric (manometry) feedback capability and its testing as a training tool on operators with a range of experiences. Methods Postal questionnaires were sent to 100 randomly selected veterinary practices. The lung model simulator was manually ventilated, in a staged process over three weeks, with and without real-time biometric feedback (PIP display), by three groups of volunteer operators: inexperienced, experienced and specialist. Results The questionnaires determined that veterinary nurses were responsible for providing the majority of manual ventilation in veterinary practices, mainly drawing on theoretical knowledge rather than any specific training. Thoracic surgery and apnoea were the main reasons for provision of manual ventilation. Specialists performed well when manually ventilating the lung model, regardless of feedback-training. Both inexperienced and experienced operators showed significant improvement in technique when using the feedback training tool: variation in PIP decreased significantly until subjects provided manual ventilation at peak inspiratory pressures within the defined optimum range. Preferences for different forms of feedback (graphical, numerical or scale display), revealed that the operators’ choice was not always the method which gave least variation in PIP. Conclusions and Clinical Relevance This study highlighted a need for training in manual ventilation at an early stage in veterinary and veterinary nursing careers and demonstrated how feedback is important in the process of experiential learning. A manometer device which can provide immediate feedback during training, or indeed in a real clinical setting, should improve patient safety.