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
- Position
- Sniffing position (neutral in infants)
- Jaw thrust if trauma suspected
- Consider shoulder roll in infants
- Mask Seal
- E-C clamp technique
- Two-person technique preferred
- Observe chest rise
- 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