Bag valve mask ventilation
Overview
- simple, life-saving skill that is critical in airway management
- oxygenation and ventilation prior to definitive airway placement
Indications
- respiratory failure
- pre-oxygenation
- emergent need to oxygenate/ventilate
Contraindications
Difficult BVM (MOANS)
- Mask seal
- Obesity
- Aged
- No teeth
- Stiffness (resistance to ventilation)
Equipment Needed
- Bag connected to oxygen at 15L/min
- mask connected to the bag
- consider PEEP valve
- OPA/NPA/adjuncts to facilitate successful BVM ventilation
Children
- proper-sized mask (covers nose and chin)
- proper bag (enough to see chest rise)
Procedure
"EC" Hand Position
- thumb and index finger holding mask in a "C" position
- thumb superior and index inferior
- 3rd, 4th, 5th finger hold the mandible and perform a jaw thrust
- other hand used to bag
2-person
- one person holds the mask with both hands (lateral edges)
- 2nd person bags
Rate
- adult bag at 10-12/min
- children 16-20/min
- infants 30/min
Tidal Volume
- avoid hyperinflation
- bag until chest rise is seen