Manual Ventilation Flashcards
Successful Bag-Mask Ventilation in an Adult will depend upon
- Positioning/Patent Airway
- Patent Airway
- Mask Seal
Positioning/Patent Airway
In Adult Ventilation
Head Tilt Chin Lift
Jaw Thrust-C-Spine
You Position-HOB
Patent Airway with Adult Ventilation
Maintain an open airway
OPA, NPA
Mask Seal with Adult Ventilation
- Appropriate mask size
- Hand positioning
- Single hand
- Lift chin up to mask
Proper Ventilation For Adult Manual Ventilation
Connect bag to mask and O2
Should not use entire volume of bag
Assessing Mask Seal For Adult Manual Ventilation
Should feel some resistance in the bag.
Does the chest rise?
Can you hear a leak?
Steps to Improve Mask Seal For Adult Manual Ventilation
- Remove mask and reseat to face
- Is airway patent
- Head tilt chin lift?
- OPA
- Suction oropharynx
- Two hand mask seal
- Reinserting patient’s false teeth
What Breaths Should You Give an Adult Patient
12 bpm
What Vt Should You Give an Adult Patient
Target 500-600 mls for an adult
What Ti Should You Give an Adult Patient
Ti 1.0s
Decrease insufflation of stomach with gentle ventilation
Esophageal sphincter opening pressures ~25cmH2O
Effective Ventilation in Adults
Chest rise and fall with ventilation-This is the goal
Breath sounds with ventilation
Improving SpO2
Capnograph waveform
Bag Mask Ventilation in a Child
Positioning/ Patent Airway
- Head Tilt Chin Lift
- Jaw Thrust
- C-Spine
- You Position
- HOB
- Children have large occiputs compared with adults
- Use an OPA
- Large tongue relative to oropharynx
Bag Mask Ventilation in a Child
Mask Seal
Appropriate mask size
Hand positioning
Lift chin up to mask
Child Airway Anatomy
Large and posterior tongue, small space.
Larynx is more superior than adults.
Epiglottis short, stubby, angled over the trachea
Angled vocal cords: try rotating ETT to correct position at anterior commissure.
Narrowest part is cricoid cartilage.
Proper Ventilation for a Child
Connect bag to mask and O2
Bag size depending on size of child
Goal is for visible chest rise
Different Volumes in the Resuscitation Bags
Infant bag ~ 240 ml
Child bag ~ 500 ml
Adult bag ~ 1600-2000ml
Child Ti
Ti will depend on size of child
0.5 -1.0 secs
Assess for Mask Seal in a Child
- Should feel some resistance in the bag.
- Does the chest rise?
- Can you hear a leak?
- Steps to improve mask seal
- Remove mask and reseat to face
- Is airway patent
- Head tilt chin lift?
- OPA
- Suction oropharynx
- Two hand mask seal
Assessment of Effective Ventilation in Children
Chest rise and fall with ventilation
Breath sounds with ventilation
Improving SpO2
Improving HR
Capnograph waveform
1.Positioning/Patent Airway in Neonates
Head Tilt Chin Lift
Newborns have large occiputs
Shoulder roll will help with positioning
Mask Seal in Neonates
Appropriate mask size
Hand positioning
Lift chin up to mask
Tight seal is required for flow inflating devices to inflate
Resuscitator Features in Neonates
Appropriate bag size
- Infant bag ~ 240 ml
Safety feature
- Pop off valve for self inflating
- Pressure manometer to guide pressures
- Set pressure and pressure relief (T piece)
Proper Ventilation for Neonates
Connect bag to mask and O2 blender
Goal is for visible chest rise
Vt for Neonates
~12-25 ml
RR for Neonates
40-60 breaths
Ti for Neonates
~0.5 sec
MRSOPA
: mask, reposition, Sxn, open, pressure, alternative
Assess for Mask Seal for Neonates
- Should feel some resistance in the bag.
- Does the chest rise?
- Can you hear a leak?
*
Steps to Improve Mask Seal in Neonates
Remove mask and reseat to face
Is airway patent-Head tilt chin lift?
Suction oropharynx
Open babes mouth slightly
Use more pressure
Assessment of Effective Ventilation for Neonates
Improving HR
Improving color
Improving tone
Improving SpO2
Chest rise and fall with ventilation
Breath sounds with ventilation
Capnograph waveform
