Resuscitation Masks and Bag-Valve Masks (BVM)

Resuscitation Masks and Bag-Valve Masks (BVM)

Overview

Resuscitation masks and bag-valve masks are essential emergency devices used to provide positive pressure ventilation in pediatric patients requiring respiratory support or cardiopulmonary resuscitation.

Key Components

  • Self-inflating bag: Available in infant (250ml), pediatric (500ml), and adult (1600-2000ml) sizes
  • Non-rebreathing valve
  • Oxygen reservoir
  • Pressure relief valve (40-45 cmH2O)
  • PEEP valve (optional attachment)
  • Face mask with soft cushioned rim

Clinical Applications

  • Respiratory failure or arrest
  • Cardiac arrest
  • Emergency airway management
  • Pre-oxygenation before intubation
  • Transport ventilation
  • Post-extubation support

Types and Sizes

Face Mask Sizes

  • Neonate: Size 0/1 (Round)
  • Infant: Size 2 (Round)
  • Toddler: Size 3 (Triangular)
  • Child: Size 4 (Triangular)
  • Small Adult: Size 5 (Triangular)

Mask Types

  • Clear Silicone Masks
    • Provides visibility of secretions/color
    • Autoclavable
    • Better seal on face
  • Cushioned Masks
    • Air-filled cushioned rim
    • Improved facial seal
    • Reduced pressure points
  • Disposable Masks
    • Single-use
    • Cost-effective
    • Infection control

Usage Technique

Proper BVM Technique

  1. Position
    • Sniffing position (neutral in infants)
    • Jaw thrust if trauma suspected
    • Consider shoulder roll in infants
  2. Mask Seal
    • E-C clamp technique
    • Two-person technique preferred
    • Observe chest rise
  3. Ventilation Rate
    • Infants: 30-60 breaths/min
    • Children: 20-30 breaths/min
    • During CPR: 1 breath every 6 seconds

Common Errors

  • Poor mask seal
  • Excessive pressure/volume
  • Inadequate head positioning
  • Wrong size selection
  • Gastric insufflation

Complications and Troubleshooting

Immediate Complications

  • Gastric Distention
    • Causes: Excessive pressure/volume
    • Prevention: Appropriate pressure, consider OG tube
  • Barotrauma
    • Pneumothorax
    • Pneumomediastinum
    • Prevention: Use pressure relief valve
  • Facial Pressure Injuries
    • Bridge of nose
    • Periorbital tissue
    • Prevention: Proper size, cushioned masks

Troubleshooting

  • Inadequate Ventilation
    • Check mask seal
    • Reposition airway
    • Consider oropharyngeal airway
    • Switch to two-person technique
  • Equipment Issues
    • Check valve assembly
    • Verify oxygen connection
    • Inspect for damage


Further Reading
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