Comparison of LASOO and CE mask ventilation techniques for female nurses with different hand lengths

ISRCTN	ISRCTN15345787
DOI	https://doi.org/10.1186/ISRCTN15345787
Sponsor	Shanxi Academy of Medical Sciences
Funder	Investigator initiated and funded

Submission date: 12/08/2026
Registration date: 14/08/2026
Last edited: 13/08/2026

Recruitment status: No longer recruiting
Overall study status: Ongoing
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
Bag-valve-mask ventilation is an important emergency resuscitation skill used to help patients breathe. Different techniques can be used to hold the mask during ventilation, but it is unclear whether hand size affects how well these techniques work.

This study aims to compare two bag-valve-mask ventilation techniques, known as the LASOO technique and the conventional CE technique, among female nurses with different hand lengths. The researchers will assess ventilation effectiveness, hand fatigue and operating performance to determine which technique works best for nurses with different hand sizes.

Who can participate?
Female licensed nurses aged 18 to 50 years who are willing to take part and provide written informed consent.

What does the study involve?
Participants will receive two hours of standardised training in bag-valve-mask ventilation and must pass a theory test before taking part in the assessment.

Participants will be randomly assigned to use either the conventional CE mask fixation technique or the LASOO mask fixation technique.

After training, participants will perform 10 consecutive ventilations using both their dominant and non-dominant hands on a simulation manikin.

Researchers will assess the volume of air delivered during ventilation, the correctness of the ventilation technique and the perceived hand fatigue after the procedure.

Two independent assessors will evaluate performance during the assessments.

What are the possible benefits and risks of participating?
Participants may improve their bag-valve-mask ventilation skills and contribute to research that could improve emergency airway management training for nurses.

The risks associated with participation are expected to be minimal and mainly relate to temporary hand fatigue during the ventilation exercises.

Where is the study run from?
Shanxi Bethune Hospital, Taiyuan, China.

When is the study starting and how long is it expected to run for?
January 2026 to December 2026.

Who is funding the study?
Investigator initiated and funded.

Who is the main contact?
Mrs Wen Li, liwen@sxbqeh.com.cn

Contact information

Mrs Wen Li
Principal investigator

No.99 Longcheng Avenue
Taiyuan, Shanxi Province
030032
China

ORCID ID	0000-0003-3978-0860
Phone	+8613503543829
Email	liwen@sxbqeh.com.cn

Mrs Jinli Cui
Public

No.99 Longcheng Avenue
Taiyuan, Shanxi Province
030032
China

Phone	+8613327463587
Email	956658137@qq.com

Miss Jingyu Ma
Scientific

No.56 Xinjian South Road
Taiyuan, Shanxi Province
030001
China

Phone	+8618035911126
Email	mjy_05@126.com

Study information

Primary study design	Interventional
Allocation	Randomized controlled trial
Masking	Open (masking not used)
Control	Active
Assignment	Factorial
Purpose	Treatment, Skill training: Evaluate airway ventilation skill performance
Scientific title	A prospective 2×2 factorial randomised controlled trial comparing ventilation performance between LASOO and CE bag-valve-mask fixation techniques among Chinese female nurses stratified by hand length
Study objectives	1.To compare ventilation efficacy between LASOO and CE BVM fixation techniques in Chinese female nurses with hand length <170mm and ≥170mm, and test the interaction effect of hand length × ventilation technique. 2.To compare the proportion of participants achieving tidal volume 400–700mL across four subgroups (short hand+CE, short hand+LASOO, normal hand+CE, normal hand+LASOO). 3.To compare subjective hand fatigue (Borg CR-10 scale) among four subgroups. 4.To evaluate operability and teaching feasibility of LASOO technique for female nurses. 5.To provide evidence-based reference for differentiated emergency ventilation skill training.
Ethics approval(s)	Approved 06/11/2025, Medical Ethics Committee of Shanxi Bethune Hospital (No.99 Longcheng Avenue, Taiyuan, Shanxi Province, 030032, China; +8603518368465; sxbqeyylyll@163.com), ref: YXLL-2025-077
Health condition(s) or problem(s) studied	Bag-valve-mask ventilation operation skill for emergency resuscitation
Intervention	Participants are stratified by hand size (small hand < 170 mm vs. non-small hand ≥ 170 mm) measured according to the Chinese national standard GB/T 16252-2023. A computer-generated random number sequence (Microsoft Excel RAND function) is used to allocate participants 1:1 to either the C-E technique or LASOO technique group, with a fixed block size of 4. For allocation concealment, sequentially numbered, opaque, sealed envelopes are used. The allocation results (A = C-E technique, B = LASOO technique) are placed in envelopes labeled only with concealment numbers. Envelopes are opened sequentially after hand-length measurement and stratification by a research assistant not involved in subsequent procedures. All participants receive unified 2-hour standardised training via modified Peyton four-step teaching method, with a closed-book theory test score ≥80 required before formal testing. 1. CE group: C-E mask fixation technique, forming a C shape with thumb-index finger to seal mask and E shape with middle-ring-little finger to lift mandible. 2. LASOO group: Five-step Lift-Apply-Slide-Oppose-Observe mask fixation technique, authorised and reviewed by original developer Dr Cliff Shelton. Each participant completes 10 consecutive bag-valve-mask ventilations with the dominant and non-dominant hand on a Laerdal QCPR manikin. Two blinded independent assessors separately record operation correctness and tidal volume data.
Intervention type	Behavioural
Primary outcome measure(s)	Mean tidal volume (mL) measured using automated recording by the Laerdal QCPR manikin and matched iPad App, averaged from 10 consecutive ventilations of dominant and non-dominant hand per participant, at an assessment immediately after standardised skill training Technique correctness rate measured using Assessor A (technique supervisor) observes and records on a standardized checklist at the ventilation procedure
Key secondary outcome measure(s)	Perceived fatigue score measured using self-reporting by participants at assessments immediately after standardised skill training after completing 10 ventilations for each hand
Completion date	31/12/2026

Eligibility

Participant type(s)
Age group	Adult
Lower age limit	18 Years
Upper age limit	50 Years
Sex	Female
Target sample size at registration	125
Key inclusion criteria	1. Female licensed nurses including advanced study nurses 2. Voluntary participation and signed written informed consent
Key exclusion criteria	1. Arthritis, tendinitis, hand fracture, nerve injury or other disorders impairing hand function 2. History of hand/wrist surgery or trauma sequela affecting hand movement 3. Congenital or acquired hand malformation 4. Neurological diseases impairing fine motor control (Parkinson’s disease, multiple sclerosis etc.) 5. Hand tactile or pressure sensory disturbance 6. Hand length <150mm or >190mm
Date of first enrolment	07/01/2026
Date of final enrolment	12/08/2026

Locations

Countries of recruitment

China

Study participating centres

Results and Publications

Individual participant data (IPD) Intention to share	No

Study outputs

Output type	Date added	Peer reviewed?	Patient-facing?
Other files	13/08/2026	No	No
Other files	13/08/2026	No	No
Protocol file	13/08/2026	No	No

Additional files

50080_Protocol.pdf: Protocol file
50080_CONSORT 2025 Checklist.pdf: Other files
50080_CONSORT Flow Diagram.pdf: Other files

Editorial Notes

12/08/2026: Study’s existence confirmed by the Medical Ethics Committee of the Shanxi Bethune Hospital, China.