Bag valve mask ventilation: Difference between revisions
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==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}} | ||
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*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 | ||
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==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== | ||
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[[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
- Respiratory failure
- Pre-oxygenation
- Emergent need to oxygenate/ventilate
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
- Readjust head-tilt-chin-lift or jaw thrust
- Utilize oropharyngeal airway/nasopharyngeal airway
- Overinflation of the stomach causing emesis/aspiration