Bag-Valve Mask (BMV)

Question 1

BMV: Also Known As (5)

Answer 1

1. AMBU
2. Manual Resuscitator
3. Bag
4. Self-inflating bag
5. Face Mask Ventilation (FMV)

Question 2

BMV: Indications (4)

Answer 2

1. Apnea / “gasping” breaths
2. Ventilation during CPR
3. Inadequate ventilation
4. Unconscious patient

Question 3

BMV: Hazards/Complications (4)

Answer 3

1. Barotrauma
2. Gastric distention
3. Hypo/Hyperventilation
4. Hemodynamic alterations

Question 4

BMV: Input Flow and FiO2

Answer 4

1. Input Flow: 10 - 15 L/min
2. FiO2: 100% (w/appropriate technique)

Question 5

BMV: Signs of effective manual ventilation (5)

Answer 5

1. Condensation (mask)
2. Bilateral breath sounds
3. Symmetrical chest rise
4. Taut and refilling bag
5. CO2 on capnography

Question 6

BMV: Notes (3)

Answer 6

1. Always look for bilateral chest rise and fall
2. Make sure face mask, O2 source and flowmeter are available.
3. Allow bag refill time

Question 7

BMV: PEEP Valve (4)

Answer 7

1. Indicated when patient’s oxygenation is not improving (Refractory hypoxemia)
2. Peep valve is attached to the Expiratory valve on BMV
3. Physiologic PEEP: Start PEEP setting at 5cmH2O. Can go up to 20cmH2O
4. PEEP valve can improve oxygenation by increasing alveolar recruitment and prevent atelectasis and lung injury

Question 8

BMV: End Tidal CO2 Indicator (4)

Answer 8

1. It is used on Intubated patients to verify that the intubation worked correctly.
2. The indicator turns from Purple to Yellow when CO2 is present.
3. Yellow on the indication (CO2 present) confirms that the intubation worked correctly
4. Connects to the patient valve on the BMV

Question 9

BMV: Positioning (2)

Answer 9

1. Head-tilt, Chin-lift or “Sniffing Position”: Used on patients with no suspected spinal injury
2. Jaw-Thrust: Used on patients with suspected/confirmed spinal injury

Question 10

BMV: Frequency of Breaths (3)

Answer 10

1. Rescue breaths: Every 6 seconds (10bpm)
2. During basic CPR: 2 breaths after each compression cycle
3. During advanced CPR: Every 6 seconds (10bpm)

Question 11

BMV: Troubleshooting
Resistance is met with bagging (4)

Answer 11

There is an Obstruction
1. Anatomic: Reposition/artificial airway
2. Excessive secretions: Suction
3. Bronchospasm: Bronchodilator
4. Foreign object: Remove F.O.

Question 12

BMV: Troubleshooting
Resistance is not met with bagging (3)

Answer 12

There is a Leak
1. Inadequate mask seal: Ensure proper position (C&E technique)
2. Valve leak: (Troubleshoot or obtain new BMV)
3. Device leak: (Troubleshoot or obtain new BMV)

Question 13

BMV: Parts of the AMBU (5)

Answer 13

1. Expiratory valve
2. Patient valve
3. Self-inflating bag
4. O2 inlet valve
5. O2 Reservoir bag