According to Hess and associates, how should the practice of allowing resuscitation victims to breathe spontaneously through the NRV of resuscitators be viewed?

A. acceptable because it gives the person performing ventilation periodic rest
B. acceptable because spontaneous breathing helps load the respiratory muscles
C. unacceptable because this practice imposes increased work of breathing
D. unacceptable because the victim cannot sustain a fixed Fio2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Spontaneous breathing through the NRV of resuscitators has been an area of controversy. Hess and colleagues found that both inspiratory and expiratory work of breathing were elevated. Imposed work of breathing increased with the application of PEEP, and with increased patient flow demand. Measurements of work in this study were high and represented a 10- to 100-fold increase compared with the imposed work of breathing associated with common ICU ventilators. Therefore Hess and associates recommend that the practice of allowing spontaneous breathing via disposable resuscitator bags be abandoned.
D. Incorrect response: See explanation C