The Manual Ventilation Academy (MVA) is proud to highlight an extraordinary three-day training event held in Hawaii last July, led by Bob Page, that showcased both the transformative power of real-time ventilation feedback and the unmatched dedication of Hawaiian EMS professionals.
Over just 72 hours, 52 new providers were trained in evidence-based manual ventilation techniques, 13 new instructors were certified to carry the mission forward, and two medical directors joined the movement to bring safe, effective ventilation to the frontlines. Every island was represented. Every participant came with one goal: to improve patient outcomes during the most critical moments of care.
But the real story was the shift in confidence—and the data that followed.
Before feedback: uncertainty and inconsistency
During the first rotation, participants ventilated without feedback—just as they do in real-life emergencies. Across the board, many providers expressed discomfort ventilating blindly, without any visual or auditory cue to guide them. They didn’t feel confident they were delivering an appropriate breath. The data reflected this concern:
- 60% of breaths leaked significantly due to mask seal issues
- 47% of ventilations were insufficient (underventilated)
- 4% were excessive (overventilated)
These numbers are not a reflection of effort—they reflect a system problem. One where we ask our providers to hit a target they can’t see.
When using ventilation feedback device: measurable improvement
Once EOlife X feedback devices were introduced (VFD), everything changed. Students could adjust in real time—breath by breath. They could immediately see whether their grip was leaking, whether their volume was too low, or whether their rate was drifting. The feedback helped them train their hands to deliver consistent, guideline-compliant ventilation every time.
The result? A dramatic improvement in consistency and confidence. With feedback, students were able to quickly establish muscle memory that would serve them in the field—when it matters most.
This training proved, unequivocally, that with feedback, providers across Hawaii can deliver safe, effective manual ventilation—in line with AHA and ERC standards. The implications for neurologically outcomes from cardiac arrest survival are profound.
Imagine the impact if every EMS engine and response vehicle had this technology in the hands of fully trained, highly motivated providers. Today, Hawaii has 52 such providers—and 13 new instructors ready to train more.
Honolulu: leading the charge toward implementation
The momentum didn’t stop at training. Honolulu EMS is now actively seeking funding to bring ventilation feedback devices into clinical practice—“to put the speedometer into the car.” These devices already exist. They are FDA-cleared for use on adult patients. And with a well-trained provider base already in place, Hawaii is in a unique position to become a national model for data-driven, patient-centered airway management.
We are eager to see what happens when these devices are deployed in real cases—and what survival curves look like when high-quality ventilation becomes the standard of care, not the exception.
To our Hawaiian partners: thank you for your commitment to progress, your openness to change, and your belief in the power of feedback. We are honored to stand with you.
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