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Adult Bag Valve Mask
Alright, so let's take a look at the bag valve mask a bit closer. Professional rescuers are encouraged to use the bag valve mask whenever possible but one important aspect of this is that it takes practice. It's not that it's rocket science at all, but it just takes practice to be able to get your fingers placed correctly and to get your own technique down with some of the hints I'm going to show you to be able to seal the mask to the face of the patient. Another mistake that's commonly made is we think
we're going to crush the mask down onto the face of the patient. When in reality, we're sealing it, but bringing the face of the patient up into the mask. Not mask down on patient's face. Face up into mask. That combined with sealing with the CE method allows us usually to get a pretty good seal. Some of the reasons you might not get a good seal
is deformity to the face, traumatic injury to the face, or a lot of facial hair. If that happens, you're going to do the best you can, but it's probably going to be an intubation patient at that point to be able to control the airway. But for this case, we're talking about basic life support with a bag valve mask. Notice, I've taken the reservoir bag off. There is no oxygen hooked up to this bag. If there were oxygen hooked up to this,
we would be at high flow oxygen delivery with bag expanded. The way you do that is cover the outlet while it's on high flow, the bag would expand and fill with air, and you're ready to start ventilating to capture as much of that percentage of oxygen as possible. But we're just going to do room air, which is perfectly acceptable as well. In fact, some statistics and studies are showing that it might be just great to do it with room air.
Remember, too, the bag valve mask is helping this person who might possibly be in cardiac arrest because we're not giving them any percentage of our carbon dioxide thereby contributing to their hypercarbia and the CO2 buildup in their body. So there is a benefit of that. The other benefit is we're not putting our face anywhere near the person's face. Therefore, protecting ourselves from infection as well.
So, when we put this on the patient's face, we're going to make sure that the narrow, pearshape of this mask is going on the bridge of the nose. Then, the wider or broader part of the mask is going to cover below the lips and above the chin. Then, coming in at the stem with our fingers, our C, our thumb and first finger, we're sealing in this case the left side of the mask
EMS Skills Bag Valve Mask Ventilation
If a patient is not adequatelyventilating on his or her own, which may mean the patient isnot breathing at all or the patient is breathing but notexchanging adequate amounts of air, it is necessary for theEMT to support ventilations mechanically. For the EMT, the tool of choiceto ventilate a patient is a bag valve mask.
The device consists of aface mask, a one way valve, and a bag. Many bag valve masks will alsoincorporate an oxygen reservoir as well. When utilizing a bag valve mask,the EMT should always utilize manual airwaytechniques, airway adjuncts, and supplemental oxygen todeliver high concentrations of oxygen to the patient whileinsuring a patent airway.
Do not hesitate to suctionthe airway if necessary. Also remember to takeappropriate cervical spine stabilization precautionsif warranted. Assembly of the bag valve maskis relatively simple. Begin by expandingthe bag itself. Attach the action reservoirbag, if included, and the face mask. Attach the oxygen tubing to thebag valve mask and connect
the other end to the regulatoron an oxygen cylinder or to a regulator withinthe ambulance. Ensure the oxygen supply is onand set the regulator at a high flow rate, typically15 liters per minute. If the EMT is functioning alone,he or she should use the EC technique forestablishing a face mask seal over the patient's face. Grasp the face mask using thepalm, thumb, and index finger
to form a C overthe face mask. Place the face mask over thepatient's nose and mouth. Utilize the remaining fingersunder the patient's jaw to form an E and anchor thehand to the face. Squeeze the bag with the otherhand delivering enough air to produce visible chestrise in the patient. Release the bag and allowit to refill with air. Squeeze again and repeat asnecessary at an appropriate
rate determined by AHA standardsor local protocol. If at any time chest rise doesnot occur when the bag is squeezed, reassessthe equipment, technique, and patient. In some instances, the rescuerfailed to maintain an adequate seal between the face maskand the patient's face. In other instances, thepatient's airway may be occluded given a foreign bodyor in proper positioning.