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Does the ResQPOD Circulatory Enhancer comply with International Standard Organization (ISO) anaesthetic connection standards?
Yes, the ResQPOD is in full compliance of ISO 5356-1, Anaesthetic and respiratory equipment – conical connectors.
What effect does adding a PEEP valve to the ventilation circuit (distal or proximal) have on the ResQPOD Circulatory Enhancer?
PEEP is compatible with the ResQPOD. If it is used, it should be placed between the ResQPOD and the ventilation source, not between the ResQPOD and the airway. One animal study has shown that low levels of PEEP may improve the efficiency of CPR with the ResQPOD 11 , but there are no human studies evaluating both the ResQPOD and PEEP to date.
What effect does adding continuous positive airway pressure (CPAP) to the ventilation circuit (distal or proximal) have on the ResQPOD?
CPAP is not compatible with the ResQPOD because it is not possible to lower intrathoracic pressure with CPAP. CPAP is contraindicated during CPR as it decreases venous blood flow back to the heart. CPAP should not be used during the performance of CPR, with or without the ResQPOD.
What effect does adding bi-level positive airway pressure (BiPAP) to the ventilation circuit (distal or proximal) have on the ResQPOD Circulatory Enhancer?
BiPAP is not compatible with the ResQPOD because any continuous positive airway pressure ventilation negates most of the effects of the ResQPOD during cardiac arrest.
Can I use the ResQPOD Circulatory Enhancer with a colormetric end tidal carbon dioxide (ETCO2) detector in the ventilation circuit to assess endotracheal (ET) tube placement or with a bag-valve resuscitator that incorporates ETCO2 detection as a feature (e.g. Capno-Flo [Mallinkrodt])?
Yes. The colormetric test results may be more positive with the ResQPOD in place if the ET is in the proper position. Place the colormetric ETCO2 detector between the ResQPOD and the ventilation source, making sure all connections are tight and do not leak.
Can I use electronic ETCO2 detection (with sidestream or mainstream gas sampling) in the same ventilation circuit as the ResQPOD Circulatory Enhancer?
Yes, as long as the sensor is placed between the ResQPOD and the ventilation source and not between the ResQPOD and the airway, which could create an air leak and, therefore, hinder the development of the vacuum.
Can I use the ResQPOD Circulatory Enhancer with bag-valve resuscitators that have an integrated "mediport" (feature that permits administration of medications via a metered dose inhaler) or to administer medications endotracheally (e.g. Medibag, Ambu)?
Yes, the ResQPOD should not affect the delivery of the medication and the medication should not affect the performance of the ResQPOD. However, this has not been clinically tested and may depend upon the medication used. If you are delivering endotracheal medications without a mediport, the manufacturer recommends that you disconnect the ResQPOD from the endotracheal (ET) tube, administer the medications directly into the ET tube, and then reconnect the ResQPOD.
Can the ResQPOD Circulatory Enhancer be used with a bag-valve resuscitator with a feature that limits flow rates (and thus airflow pressures) during ventilation (e.g. SMART BAG)?
Yes. This feature will not affect the ResQPOD’s function.
Can I use the ResQPOD with the Oxylator?
No. In the automatic mode, the Oxylator provides a continuously positive airway pressure that is harmful for the patient, with or without the ResQPOD. This continuously positive airflow interferes with the ResQPOD’s ability to create a vacuum (negative pressure). ACSI and the American Heart Association discourage the use of the Oxylator in the automatic mode during CPR, it will decrease circulation.
Can the ResQPOD Circulatory Enhancer be used on a patient with a tracheostomy or stoma?
A patient with a stoma could have an endotracheal tube placed into the stoma for airway management. If there is not a good seal between the airway device and the lungs, the ResQPOD may be less effective. As long as there is an adequate seal during positive pressure ventilation, the ResQPOD should work effectively. It is the ultimate decision of the prescribing physician to determine in what ages of patients the ResQPOD should be used.
Can the ResQPOD Circulatory Enhancer be used on an uncuffed endotracheal tube?
If there is not a good seal between the airway device and the lungs, the ResQPOD may be less effective. As long as there is an adequate seal during positive pressure ventilation, the ResQPOD should work effectively. It is the ultimate decision of the prescribing physician to determine in what ages of patients the ResQPOD should be used.
Can the ResQPOD Circulatory Enhancer be used with any standard facemask?
Yes; however, the manufacturer strongly recommends that the user consider the quality of the facemask to use it with. Obtaining and maintaining an adequate seal during facemask ventilation is critically important to the generation of the all-important vacuum. Many standard facemasks purchased today are selected primarily based upon cost, not mask quality. ACSI recommends that anyone who is going to use the ResQPOD on a facemask use one with excellent face-sealing qualities. A 2-person ventilation technique, as recommended by the American Heart Association, is preferred.
The current model of ResQPOD requires a 15 mm/22 mm adaptor in order to attach it to a standard facemask; no adaptor is required for connection to an endotracheal tube. At the present time, the ResQPOD comes packaged with this adaptor. Sometime in the summer of 2005, the next model of ResQPOD will come out (same product number). This model will not require an adaptor for connection to any airway adjunct and will have two timing assist lights instead of three. A special sticker will be placed on the packaging so that the user will know that an adaptor is no longer required.
I see that the ResQPOD can be used for mouth-to-mask ventilation, but the ResQPOD doesn’t come packaged with a mouthpiece. How can I get one?
Most mouthpieces with standard adaptors will work. One source for mouthpieces that will work with the ResQPOD is: Qosina, 150-Q Executive Drive, Edgewood, NY 11717-8329; phone: 631-242-3000; fax: 631-242-3230; website: www.qosina.com; product name: 22 mm OD mouthpiece; part #: 55901.
Can I use the ResQPOD Circulatory Enhancer on a Combitube, laryngeal mask airway (LMA), esophageal obturator airway (EOA), Cobra, or other advanced airway?
The ResQPOD is cleared for use on airway adjuncts used during assisted ventilation. The ResQPOD will fit on these advanced airway devices and should be effective as long as there is a sufficient seal within the ventilation circuit.
Has the ResQPOD Circulatory Enhancer been tested with semi-open anesthetic circuits (e.g. Bain, McGill, Lack) as these are used in emergency resuscitation rooms connected to resuscitation machines?
The ResQPOD has not been tested in semi-open anesthetic circuits; however, there is no known reason that the ResQPOD should not work with these machines.
Has the ResQPOD Circulatory Enhancer been tested with Soda Lime Absorber “Closed Circuit” anesthetic systems, which are also used in resuscitation areas?
The ResQPOD has not been tested in closed circuit anesthetic systems; however, there is no reason to believe that the ResQPOD would not work.
When expiration release pressures are high, minute volume dividers and pressure-cycled resuscitators may respond with a high respiratory rate and low breath volumes. Most EMS ventilators and BVM devices can be fitted with a break valve pressure of between 45 and 60 cmH2O. Does this affect ResQPOD performance?
This should not alter the performance of the ResQPOD.
Does the application of cricoid pressure interfere with ResQPOD performance?