Ventilation - BLS Flashcards
Q: What is the purpose of mouth-to-mouth ventilation?
A: To inflate the lungs of someone who has stopped breathing, using exhaled air, to maintain life until advanced airway management is available.
Q: What is the oxygen concentration in exhaled air during mouth-to-mouth ventilation?
A: 16–17%, which is less than oxygen-enriched air and should be replaced by advanced ventilation as soon as possible.
Q: When is mouth-to-mouth ventilation contraindicated?
A: For patients with suspected or confirmed COVID-19, due to a higher risk of disease transmission.
Q: What should be done if a face shield is available during mouth-to-mouth ventilation?
A: Use the shield to reduce the risk of disease transmission, following the same technique as without the shield.
Q: What is the first step before starting mouth-to-mouth ventilation?
A: Perform 30 chest compressions to prepare for delivering rescue breaths.
Q: How should the patient’s head be positioned for mouth-to-mouth ventilation?
A: Tilt the head back into the “sniffing the morning air” position to lift the tongue off the back of the throat and open the airway.
Q: Why is it important to pinch the nose during mouth-to-mouth ventilation?
A: To stop air from escaping through the nose during rescue breaths.
Q: What is the correct technique for delivering rescue breaths?
A:
- Take a normal breath.
- Seal your mouth over the patient’s mouth.
- Breathe out steadily over about 1 second, watching for the chest to rise.
- Remove your mouth and check for the chest to fall.
Q: What should you do if the chest does not rise during mouth-to-mouth ventilation?
A:
- Recheck the airway by tilting the head further back.
- Ensure the airway is clear.
- Attempt another rescue breath, ensuring a proper seal and steady exhalation.
Q: How many attempts at rescue breaths should be made if the chest does not rise?
A: Only two attempts should be made before returning to chest compressions.
Q: What is the correct ratio of chest compressions to rescue breaths during CPR?
A: 30 chest compressions to 2 rescue breaths.
Q: What is the next step after delivering two successful rescue breaths?
A: Resume chest compressions immediately, continuing the CPR cycle.
Q: How should the breath be delivered to avoid forcing air into the stomach?
A: Deliver the breath steadily, avoiding sharp exhalation.
Q: What personal protective equipment (PPE) should be worn during mouth-to-mouth ventilation?
A: PPE appropriate to the situation, following local and national guidelines.
Q: Why should dentures only be removed if visible as an obstruction?
A: Blindly removing dentures could dislodge or push other obstructions further back into the airway.
Q: What should you consider before performing mouth-to-mouth ventilation?
A: The environment must be safe, and risks of infection to the practitioner should be minimized.
Q: What is the purpose of the “sniffing the morning air” position during mouth-to-mouth ventilation?
A: It ensures the tongue lifts off the back of the throat, opening the airway for effective ventilation.
Q: What should be done before positioning the patient for mouth-to-mouth ventilation?
A: Ensure the environment is safe and put on appropriate PPE as soon as possible.
Q: What is the significance of observing the chest during rescue breaths?
A: Watching for chest rise confirms that the breath is effectively inflating the lungs, and checking for chest fall ensures proper exhalation.
Q: Why should breaths not be exhaled sharply during mouth-to-mouth ventilation?
A: Sharp exhalation may force air into the stomach, increasing the risk of gastric inflation and potential aspiration.
Q: What should you do immediately if rescue breaths fail to inflate the chest?
A: Resume chest compressions without delay, following the CPR cycle.
Q: Why is it important to limit rescue breath attempts to two if the chest does not rise?
A: To minimize interruptions to chest compressions, which are critical for maintaining circulation during CPR.
Q: What is the recommended action if advanced airway equipment is not available during CPR?
A: Continue basic life support techniques, including chest compressions and rescue breaths, until professional help or equipment arrives.
Q: What does the European Resuscitation Council advise about the risk of disease transmission during mouth-to-mouth ventilation?
A: The risk is considered low, but extra precautions should be taken during high-infection-risk scenarios such as COVID-19.
Q: How does the use of a face shield impact mouth-to-mouth ventilation?
A: It makes the procedure more comfortable and reduces the risk of disease transmission, but the technique remains the same.
Q: What is a bag-valve-mask device used for?
A: It is used for manual ventilation of patients who cannot breathe on their own, delivering higher oxygen concentrations during resuscitation or anesthesia.
Q: How many practitioners are typically required to operate a bag-valve-mask?
A: Two practitioners: one holds the mask in place and maintains the airway, while the other squeezes the bag.
Q: What precautions must be taken before using a bag-valve-mask?
A: Ensure the environment is safe, follow local PPE guidelines, and check the airway for obstructions.
Q: What should be checked before applying a bag-valve-mask?
A: Ensure the mask is the correct size, fits comfortably, and forms a good seal without air leaks.
Q: How should oxygen flow be set for a bag-valve-mask device?
A: Use a high-flow rate of 10–15 L/min to ensure adequate oxygen delivery.
Q: What is the purpose of a reservoir bag on a bag-valve-mask device?
A: It helps deliver a higher concentration of oxygen by drawing in oxygen instead of air when the bag reinflates.
Q: What additional equipment can be used with a bag-valve-mask?
A: An oropharyngeal or nasopharyngeal airway to maintain airway patency, or a tracheal tube for advanced airway management.
Q: How should the head be positioned for effective bag-valve-mask ventilation?
A: Tilt the head back slightly to open the airway, lifting the tongue off the back of the throat.
Q: What is the proper technique for squeezing the bag during ventilation?
A: Squeeze firmly but gently over 1 second, enough to see the chest rise, without fully emptying the bag to avoid gastric distension.
Q: What should be monitored during bag-valve-mask ventilation?
A: The rise and fall of the patient’s chest to ensure adequate ventilation.
Q: What is the compression-to-ventilation ratio during CPR with a bag-valve-mask?
A: 30 chest compressions to 2 ventilations, continuing until an advanced airway is secured.
Q: How is ventilation adjusted after securing an airway with a tracheal or supraglottic tube?
A: Deliver one breath every 6 seconds (10 breaths per minute) while chest compressions continue without pausing.
Q: What should be avoided during bag-valve-mask ventilation?
A: Do not squeeze the bag sharply or fully, as this may cause gastric distension and reduce ventilation effectiveness.
Q: Why is it essential to clear the airway before using a bag-valve-mask?
A: Obstructions can block ventilation, and blindly inserting fingers may push debris further into the airway.
Q: What is the importance of proper mask placement during ventilation?
A: A correctly positioned mask ensures no air leaks, improving the efficiency of oxygen delivery.
Q: What should be done if the chest does not rise during ventilation?
A: Check the airway for obstructions, adjust the head tilt, and ensure a proper mask seal.
Q: What is the main advantage of using a bag-valve-mask device with a reservoir bag?
A: It allows for the delivery of a higher concentration of oxygen by drawing oxygen instead of air when the bag reinflates.
Q: When is a one-person bag-valve-mask technique acceptable?
A: Only if the practitioner is competent and trained in the technique, as it requires holding the mask in place while squeezing the bag.
Q: Why should the self-inflating bag not be fully emptied during ventilation?
A: Fully emptying the bag can lead to gastric distension, which increases the risk of aspiration and reduces ventilation efficiency.
Q: What should practitioners do if the mask does not fit securely or has air leaks?
A: Reposition the mask or select a better-fitting mask to ensure an airtight seal.
Q: Why is cervical spine injury a consideration during bag-valve-mask ventilation?
A: Avoid excessive head tilt in patients with suspected spinal injuries to prevent worsening the injury.
Q: What is the significance of using high-flow oxygen with a bag-valve-mask?
A: High-flow oxygen ensures that the patient receives as much oxygen as possible during resuscitation.
Q: What are the common sizes of bag-valve-mask devices, and who are they for?
A:
250 mL: Preterm to term infants.
500 mL: Infants to 5 years old.
1 L: Older children.
1.5 L: Adults.
Q: What should be done if ventilation remains inadequate despite adjustments?
A: Consider inserting an oropharyngeal or nasopharyngeal airway to improve airway patency.
Q: How can practitioners reduce the risk of infection during bag-valve-mask ventilation?
A: Follow national and local PPE guidelines, including wearing gloves, masks, and eye protection.
Q: What role does the Yankauer suction catheter play during bag-valve-mask ventilation?
A: It helps remove debris or secretions from the airway to ensure a clear path for ventilation.
Q: How can practitioners maintain an open airway during bag-valve-mask ventilation?
A: Use the head-tilt/chin-lift maneuver or an oropharyngeal/nasopharyngeal airway.
Q: Why must the oxygen tubing be checked during assembly of the bag-valve-mask?
A: To ensure it is long enough and securely connected for proper oxygen flow without interruptions.
Q: What should practitioners monitor continuously during ventilation with a bag-valve-mask?
A: The patient’s chest movement to confirm effective ventilation and detect any issues like airway obstruction.
Q: Why is it important to explain procedures to the patient when possible?
A: It helps reduce anxiety, even in emergencies, and ensures informed care when patients are semi-conscious.
Q: What are the limitations of a bag-valve-mask device in emergencies?
A: It requires significant skill to use effectively with one person and can be difficult to maintain a good seal, especially in patients with facial abnormalities.
Q: What is the best way to ensure no air leaks around the mask during ventilation?
A: The mask should be held firmly on the face, with the soft rim forming a secure seal.
