Of the time, air enters the stomach when ventilating the lungs with a manual resuscitator.9

The Solution

Sotair® employs a flow limiting and pressure control valve mechanism to minimize complications associated with overventilation. The Sotair® minimizes excessive pressure in the airway system without venting air by capping peak flow rates at 55 L/min.

Pressure Delivered During Manual Ventilation

Sotair® limits the flow of air at 55 L/min. For an average adult, this corresponds to a maximum pressure of approximately 20 cmH2O. Air enters the stomach beyond 20 cmH2O causing gastric insufflation.

ADULT Sotair® Device Features

  • Flow limiting valve limits the inspiratory flow to 55L/min
  • Minimizes air entry into the stomach
  • Compatible with manual resuscitators, airway and adjuncts that use standard 15/22 mm connectors
  • Hospital, emergency, and transport care use
  • Adult, single patient use

How Does Sotair® Work?

When flow rates delivered with the bag exceed 55 L/min, the device activates and blocks the flow of air providing haptic, auditory, and visual feedback to the user.
Flow <=55L/min
Valve not activated
Air delivery
Flow >55L/min
Valve activated
No Air delivery

The ADULT Sotair® Device in the British Medical Journal, Innovations

During the COVID-19 pandemic, it was anticipated that there will be a shortage of mechanical ventilators. An alternative may be to implement manual ventilation in these situations. 47 volunteer providers completed two, one-hour manual ventilation sessions. Providers were randomized to complete their initial session either with or without Sotair®.

Sotair® Performance, Closer to a Ventilator's

The study showed wide variability in tidal volume and peak pressures in the bag alone arm of the study despite prior training. Additionally, peak pressures (p>.0001) and tidal volumes (p>0.0001) were significantly improved with the Sotair® device and authors concluded that extended manual ventilation may be feasible with a safety device, which may reduce barotrauma, under-ventilation and over-ventilation.10


Grant 1U54HL143541 (NHLBI) funded a 40-provider pilot bench evaluation of Sotair® with North Providence Fire Station. Implementation of Sotair® showed a 36% improvement in manual ventilation.11   Learn More

Pre-Post Sotair® Implementation at a Fire & EMS Service