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    Bag Mask Ventilation

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    edrinsne
    Bag-mask ventilation is used to ventilate and oxygenate patients by sealing a mask to the face and squeezing a ventilation bag to push air or oxygen into the lungs. It can be done with a self-inflating bag that refills on its own after each squeeze or a flow-inflating bag that requires an oxygen source. The mask should form an airtight seal and the chest should visibly rise with each squeeze. Complications include vomiting, aspiration, and barotrauma from excessive pressure or volumes. Monitoring includes pulse oximetry and heart rate checks.

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    © All Rights Reserved
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    Bag Mask Ventilation

    Uploaded by

    edrinsne
    971 views35 pages
    Bag-mask ventilation is used to ventilate and oxygenate patients by sealing a mask to the face and squeezing a ventilation bag to push air or oxygen into the lungs. It can be done with a self-inflating bag that refills on its own after each squeeze or a flow-inflating bag that requires an oxygen source. The mask should form an airtight seal and the chest should visibly rise with each squeeze. Complications include vomiting, aspiration, and barotrauma from excessive pressure or volumes. Monitoring includes pulse oximetry and heart rate checks.

    Original Description:

    bag mask ventilation (practical)

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    Bag-mask ventilation is used to ventilate and oxygenate patients by sealing a mask to the face and squeezing a ventilation bag to push air or oxygen into the lungs. It can be done with a self-inflating bag that refills on its own after each squeeze or a flow-inflating bag that requires an oxygen source. The mask should form an airtight seal and the chest should visibly rise with each squeeze. Complications include vomiting, aspiration, and barotrauma from excessive pressure or volumes. Monitoring includes pulse oximetry and heart rate checks.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    971 views35 pages

    Bag Mask Ventilation

    Uploaded by

    edrinsne
    Bag-mask ventilation is used to ventilate and oxygenate patients by sealing a mask to the face and squeezing a ventilation bag to push air or oxygen into the lungs. It can be done with a self-inflating bag that refills on its own after each squeeze or a flow-inflating bag that requires an oxygen source. The mask should form an airtight seal and the chest should visibly rise with each squeeze. Complications include vomiting, aspiration, and barotrauma from excessive pressure or volumes. Monitoring includes pulse oximetry and heart rate checks.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 35

    Bag-Mask Ventilation

    Positive pressure ventilation


    Ventilation of the lungs
    single most important and most
    effective step in cardiopulmonary
    resuscitation of the compromised
    newborn

    INDICATIONS
    To ventilate and oxygenate a patient.
    A ventilation face mask may be used
    with an oropharyngeal or
    nasopharyngeal airway during
    spontaneous, assisted, or controlled
    ventilation.

    CONTRAINDICATIONS
    In patients with full stomach, cricoid
    pressure must be maintained to
    avoid vomiting and aspiration.
    Risks
    vomiting and aspiration.

    EQUIPMENT
    Ventilation bags (manual resuscitator) come in 2
    types: self-inflating bag and flow-inflating bag.
    Ventilation bags used for resuscitation should be self
    inflating.
    Ventilation bags come in different sizes: infant, child,
    and adult.
    Face masks come in many sizes.
    A ventilation mask consists of a rubber or plastic
    body, a standard connecting port, and a rim or face
    seal.
    Supplemental oxygen can be attached to ventilation
    bags to provide oxygen to the patient.

    A good resuscitation bag


    Size 200-750 ml
    Capable of avoiding excessive
    pressure
    A pressure pop-off valve and/or a
    pressure gauge manometer

    Capable of giving 100% oxygen


    Appropriate sized mask

    Resuscitation bags
    Two types
    Flow inflating bag (anesthesia bag)
    Self inflating bag

    Flow inflating bag

    Flow inflating bag


    Fill only when oxygen from a
    compressed source flows into them
    Depend on a compressed gas source
    Must have a tight face-mask seal to
    inflate
    Use a flow-control valve to regulate
    pressure-inflation

    Flow inflating bag will not


    work if
    The mask is not properly sealed over
    the newborns nose and mouth
    There is a tear in the bag
    The flow-control valve is open too
    wide.
    The pressure gauge is missing

    Flow inflating bag


    Advantages

    Delivers 100% oxygen at all times


    Easy to determine the adequacy of
    seal
    Stiffness of lungs can be felt
    Can be used to deliver 100% free
    flow oxygen

    Flow inflating bag


    Disadvantages

    Requires a tight seal to remain


    inflated
    Requires a gas source to inflate
    No safety pop-off valve
    Requires more experience

    Self inflating bag

    Self inflating bag


    Fill spontaneously after they are squeezed,
    pulling oxygen or air into the bag
    Remain inflated at all times
    Can deliver positive-pressure ventilation without
    a compressed gas source; user must be certain
    the bag is connected to an oxygen source for the
    purpose of neonatal resuscitation
    Require attachment of an oxygen reservoir to
    deliver 100% oxygen

    Without Reservoir

    With Reservoir

    Self inflating bag


    Advantages

    Does not need a gas source to inflate


    Pressure release valve
    Easier to use

    Self inflating bag


    Disadvantages

    Will inflate even without adequate


    seal
    Requires a reservoir to deliver 100%
    oxygen
    Can not be used to deliver 100% free
    flow oxygen

    Masks
    Cushioned/Non-cushioned
    Round/Anatomical shaped
    Size 0 or 1

    Correct position of mask

    Testing the self-inflating bag


    Squeeze against your palm
    Pressure felt
    Pressure release valve
    Pressure manometer
    Re-inflation

    Sizes:
    Bag
    Adult------1600 ml.
    Child-------500 ml.
    Infant-------500 ml.
    Mask
    Adult------Size 4
    Child------Size 2
    Infant------Size 1
    Reservoir
    Adult------suitable for 1600 ml. bag
    Child / Infant---Suitable for 500 ml. bag
    Tubing
    Having suitable connectors at both
    ends for easy and safe connections.

    Bag-mask ventilation gives the clinician time to


    prepare for more definitive airway management.
    Good technique involves preserving good maskface seal, inflating the chest with minimal
    required pressure, and maintaining the optimal
    patency of the upper airway through
    manipulation of the mandible and cervical spine.
    The mask should extend from the bridge of the
    nose to the cleft of the chin, enveloping the nose
    and mouth but avoiding compression of the eyes.
    The mask should provide an airtight seal.
    The goal of ventilation with a bag and mask
    should be to approximate normal ventilation.

    PATIENT PREPARATION
    Sedation may be required before
    beginning.

    PATIENT POSITIONING
    A neutral sniffing position without
    hyperextension of the neck is usually
    appropriate for infants and toddlers.
    Avoid extreme hyperextension in
    infants because it may produce airway
    obstruction.
    In patients with head or neck injuries,
    the neck must be maintained in a
    neutral position.

    ANATOMY REVIEW
    The upper airway consists of the oropharynx, the
    nasopharynx, and supraglottic structures.
    The cricoid cartilage is the first tracheal ring,
    located by palpating the prominent horizontal
    band inferior to the thyroid cartilage and
    cricothyroid membrane.
    Cricoid pressure occludes the proximal esophagus
    by displacing the cricoid cartilage posteriorly. The
    esophagus is compressed between the rigid cricoid
    ring and the cervical spine.

    PROCEDURE

    Sequence
    Open the airway via chin lift/jaw thrust maneuver.
    Seal the mask to the face.
    Deliver a tidal volume that makes the chest rise.

    E-C Clamp Technique


    Tilt the head back and place a towel beneath the
    head.
    If head or neck injury is suspected, open the
    airway with the jaw thrust technique without
    tilting the head.
    If a second person is present, have that person
    immobilize the spine.

    Apply the mask to the face.


    Lift the jaw using the third, fourth, and fifth fingers
    from the left hand under the angle of the mandible;
    this forms the E
    The thumb and forefinger form a C shape to tightly
    seal the mask onto the face while the remaining
    fingers of the same hand form an E shape to lift the
    jaw, pulling the face toward the mask.

    When lifting the jaw, the tongue is also lifted


    away from the posterior pharynx.
    Do not put pressure on the soft tissues under the
    jaw because this may compress the airway.

    Place the thumb and forefinger of the left


    hand in a C shape over the mask and exert
    downward pressure
    Create a tight seal between the mask and the
    patients face using the left hand and lifting the
    jaw.
    Compress the ventilation bag with the right hand.
    Be sure the chest rises visibly with each breath.

    If 2 people are present, then 1 person


    can hold the mask to the face while
    the other person ventilates with the
    bag.
    One person uses both hands to open the
    airway and maintain a tight mask-to-face
    seal
    The second person compresses the
    ventilation bag.

    If 2 or 3 people are present, someone can


    apply pressure to the cricoid cartilage
    (termed Sellick maneuver) to limit
    gastric distention in unconscious patients
    The Sellick maneuver may also prevent
    regurgitation and aspiration of gastric
    contents.
    Avoid excessive cricoid pressure because it
    may produce tracheal compression and
    obstruction or distortion of the upper airway
    anatomy.

    To relieve gastric distention, a nasogastric


    tube can be placed (if not
    contraindicated).

    MONITORING
    Use pulse oximetry to measure
    oxygen saturation levels
    continuously.
    Measure heart rate continuously.
    Check blood pressure using a
    noninvasive device.
    Ensure the chest rises visibly.

    COMPLICATIONS
    Reduction in cardiac output.
    Vomiting and aspiration.
    Air trapping, barotrauma, air leak,
    and reduced cardiac output can be
    caused by excessive tidal volume
    and rate in patients with small airway
    obstruction (eg, asthma and
    bronchiolitis).

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