Using Bag Valve Mask During CPR

A bag valve mask is usually used in emergency cases and cardiopulmonary resuscitation. This is a substitute to mouth to mouth resuscitation, essential in cases where in the victim's mouth is fractured or when the victim has an infectious illness transferable by mouth and places the rescuer at risk. A bag valve mask is important during CPR.

  1. Perform the head-tilt-chin lift maneuver to open the victim's airway
  2. Create a good mask-face seal by forming a C with your thumb and forefinger and using your other fingers, grasp the jaw, holding the mask firmly against the face.
  3. In some patients, obtaining a seal may be difficult. An assistant may be needed to use two hands to obtain the seal.
  4. Also consider the tidal volume being delivered. For both adults and children, tidal volume should be about 10 to 15 cc/kg. A 12 kg 1-year-old child should receive a tidal volume of 120 to 180 cc, while a 70 kg adult should receive a tidal volume of 700 to 1050 cc.
  5. The rise and fall of the chest is an indication that the patient is being well ventilated.
  6. You can use a bag-valve mask with an attached pressure monitor. These disposable devices are inexpensive and may be adapted to most Bag-valve masks. By knowing how much pressure is being created, this helps the user of bag-valve mask to deliver the correct tidal volume.
  7. 12 to 15 ventilations per minute is required in adults. When severe asthma, a rate of only 7 to 8 ventilations per minute may be indicated.
  8. The Cricoid pressure (Sellick's maneuver) should be optional and may not prevent gastric insufflation and regurgitation.
  9. Watch out for the degree of resistance felt when the lungs are ventilated. Decreased lung compliance is a result of asthma and lung contusion. When this happens, it may be necessary to use unusually large amounts of pressure.
  10. A form of positive end expiratory pressure may also be administered with a Bag-valve mask by maintaining compression of the bag for about a second at the end of the victim's inspiration of air.

Important things to consider:

  • The compression of the valve should time with the victim's inhalation and the inflation of the valve should time with the victim's exhalation. Improper performance will lead to complications such as gastric reflux, distention of the stomach and even asphyxia
  • Proper wearing of the bag valve mask to the victim should be observed using the C-E technique
  • Before applying the mask on to the victim's mouth, place him or her in “sniffing” position with the head tilt chin lift maneuver. Or if you suspect a jaw injury, do the jaw thrust maneuver.
  • You may apply slight pressure in the cricoid area to prevent the reflux of gastric contents, which is fatal for the victim.

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