Bag valve mask ventilation: Difference between revisions

(format)
No edit summary
(5 intermediate revisions by 2 users not shown)
Line 5: Line 5:


==Indications==
==Indications==
*Respiratory failure
*[[Respiratory failure]]
*Pre-oxygenation
*Pre-oxygenation
*Emergent need to oxygenate/ventilate
*Emergent need to oxygenate/ventilate


==Contraindications==
==Contraindications==
No absolute contraindications
{{Difficult BVM}}
{{Difficult BVM}}


Line 16: Line 17:
*Mask connected to the bag
*Mask connected to the bag
*Consider PEEP valve (provides PEEP between ventilations)
*Consider PEEP valve (provides PEEP between ventilations)
*OPA/NPA/adjuncts to facilitate successful BVM ventilation
*[[OPA]]/NPA/adjuncts to facilitate successful BVM ventilation
*Suction
*Suction
*SpO2 monitor helpful
*SpO2 monitor helpful
Line 43: Line 44:
==Complications==
==Complications==
*Poor seal
*Poor seal
**Remove dentures to intubate; keep them in to bag/mask ventilate
**For a beard can smear lube to help create better seal
*Poor oxygenation/ventilation
*Poor oxygenation/ventilation
**Readjust head-tilt-chin-lift or jaw thrust
**Utilize [[oropharyngeal airway]]/[[nasopharyngeal airway]]
*Overinflation of the stomach causing emesis/aspiration
*Overinflation of the stomach causing emesis/aspiration


==See Also==
==See Also==
*[[Intubation]]
*[[Intubation]]
*[[Oropharyngeal airway]]


==External Links==
==External Links==
Line 55: Line 61:


[[Category:Procedures]]
[[Category:Procedures]]
[[Category:Critical Care]]
[[Category:EMS]]

Revision as of 13:39, 7 October 2019

Overview

  • Simple, life-saving skill that is critical in airway management
  • Deliver oxygen at positive pressure via a bag containing oxygen connected to a mask placed over a patient's nose and mouth
  • Oxygenation and ventilation prior to definitive airway placement or bridge to sedative metabolization

Indications

Contraindications

No absolute 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 (provides PEEP between ventilations)
  • OPA/NPA/adjuncts to facilitate successful BVM ventilation
  • Suction
  • SpO2 monitor helpful

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
  • Neonates 40-60/min

Tidal Volume

  • Avoid hyperinflation
  • Bag until chest rise is seen

Complications

  • Poor seal
    • Remove dentures to intubate; keep them in to bag/mask ventilate
    • For a beard can smear lube to help create better seal
  • Poor oxygenation/ventilation
  • Overinflation of the stomach causing emesis/aspiration

See Also

External Links

References