Question: A recent study, published in the Lancet showed an alternative way of performing a Valsalva maneuver, that is much more effective.

It is described and shown in a video here:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61485-4/abstract

Is it acceptable for us to perform this when a Valsalva is called for in our directives?