A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study

San Román-Mata, Silvia; Darné, Marc; Herrera-Pedroviejo, Ernesto; Otero-Agra, Martín; Navarro-Patón, Rubén; Barcala-Furelos, Roberto; Aranda-García, Silvia

doi:10.3390/healthcare13121428

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A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study

by

Silvia San Román-Mata

^1,2

,

Marc Darné

³,

Ernesto Herrera-Pedroviejo

⁴,

Martín Otero-Agra

^1,5

,

Rubén Navarro-Patón

⁶

,

Roberto Barcala-Furelos

^1,*

and

Silvia Aranda-García

³

¹

REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain

²

Department of Nursing, University of Granada, 18071 Granada, Spain

³

GRAFAIS Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), University of Barcelona, 08007 Barcelona, Spain

⁴

Blanquerna Facultad de Ciencias de la Salud, Universitat Ramon Llull, 08025 Barcelona, Spain

⁵

School of Nursing, University of Vigo, 36005 Pontevedra, Spain

⁶

Faculty of Teacher Training, Universidade de Santiago de Compostela, 27001 Lugo, Spain

^*

Author to whom correspondence should be addressed.

Healthcare 2025, 13(12), 1428; https://doi.org/10.3390/healthcare13121428

Submission received: 8 April 2025 / Revised: 9 June 2025 / Accepted: 11 June 2025 / Published: 14 June 2025

(This article belongs to the Section Prehospital Care)

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Abstract

Aim: The present study evaluated the feasibility and quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer, comparing the over-the-head (OTH) technique using mouth-to-pocket mask ventilation with bag-valve mask (BVM) ventilation. The study analyzed the chest compression (CC) quality, ventilation adequacy, interruption minimization, and the rescuers’ perceived difficulty. Methods: A randomized simulation crossover study was conducted with 26 lifeguard students trained in basic life support and both ventilation techniques. All of the participants performed two solo CPR trials (2 min each) using OTH with a pocket mask or BVM on a manikin connected to a feedback system (Little Anne QCPR, Laerdal). The overall CPR quality, ventilation, and CC quality were assessed, along with the perceived difficulty (scale 0–5). A 5 min rest was provided between the trials. Results: The overall CPR quality was excellent for both techniques with a median of 98% (IQR: 97–99) for BVM-OTH and 99% (IQR: 94–99) for Pocket-OTH (p = 0.31). The ventilation quality was better when using BVM-OTH (100%, IQR: 99–100) compared to that with Pocket-OTH (99%, IQR: 77–100; p = 0.046). No differences were found in the CC quality (99%, IQR: 99–100; p = 0.24). However, Pocket-OTH had more CCs and shorter interruption times (p ≤ 0.001). The perceived difficulty was low for both techniques. Conclusions: Both techniques enable high-quality CPR when performed alone. Given that no clinically relevant differences emerged in the resuscitation quality, the OTH technique using a pocket mask offers a viable alternative, particularly in scenarios with a single rescuer and limited resources.

Keywords: basic life support training; resuscitation quality; ventilations; mouth-to-pocket-mask; training

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MDPI and ACS Style

San Román-Mata, S.; Darné, M.; Herrera-Pedroviejo, E.; Otero-Agra, M.; Navarro-Patón, R.; Barcala-Furelos, R.; Aranda-García, S. A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study. Healthcare 2025, 13, 1428. https://doi.org/10.3390/healthcare13121428

AMA Style

San Román-Mata S, Darné M, Herrera-Pedroviejo E, Otero-Agra M, Navarro-Patón R, Barcala-Furelos R, Aranda-García S. A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study. Healthcare. 2025; 13(12):1428. https://doi.org/10.3390/healthcare13121428

Chicago/Turabian Style

San Román-Mata, Silvia, Marc Darné, Ernesto Herrera-Pedroviejo, Martín Otero-Agra, Rubén Navarro-Patón, Roberto Barcala-Furelos, and Silvia Aranda-García. 2025. "A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study" Healthcare 13, no. 12: 1428. https://doi.org/10.3390/healthcare13121428

APA Style

San Román-Mata, S., Darné, M., Herrera-Pedroviejo, E., Otero-Agra, M., Navarro-Patón, R., Barcala-Furelos, R., & Aranda-García, S. (2025). A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study. Healthcare, 13(12), 1428. https://doi.org/10.3390/healthcare13121428

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A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study

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