Bag valve mask

Information about Bag valve mask

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A BVM Resuscitator
A bag valve mask (also known as a BVM or Ambu bag) is a hand-held device used to provide ventilation to a patient who is not breathing or who is breathing inadequately. The device is a normal part of a resuscitation kit for trained professional, such as ambulance crew. The BVM is frequently used in hospitals, and is an essential part of a crash cart. The device is used extensively in the operating room to ventilate an anesthetized patient in the minutes before an electric ventilator is attached. The device is self-filling with air, although additional oxygen (O2) can be added.

Use of the BVM to ventilate a patient is frequently called "bagging" the patient.[1] Bagging is regularly necessary in medical emergencies when the patient's breathing is insufficient (respiratory failure) or has ceased completely (respiratory arrest). The BVM resuscitator is used in order to manually provide mechanical ventilation in preference to mouth-to-mouth resuscitation (either direct or through an adjunct such as a pocket mask.

Components

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One type of bag valve mask. The part labelled 1 is a flexible mask designed to seal to the patient's face, and the part labelled 3 is a self-filling bag.


The BVM consists of a flexible air chamber, about the size of an American football, attached to a face mask via a shutter valve. When the air chamber or "bag" is squeezed, the device forces air into the patient's lungs; when the bag is released, it self-inflates, drawing in ambient air or oxygen supplied from a tank. A bag valve mask can be used without being attached to an oxygen tank to provide air to the patient, but supplemental oxygen is recommended since it increases the amount of oxygen reaching the patient. Some devices also have a reservoir which can fill with oxygen while the patient is exhaling (a process which happens passively), in order to increase the amount of oxygen that can be delivered to the patient by about twofold.[1] A BVM should have a valve which prevents the patient from rebreathing exhaled air and which can connect to tubing to allow oxygen to be provided through the mask.

Bag valve masks come in different sizes to fit infants, children, and adults. Some types of the device are disposable, while others are designed to be cleaned, disinfected, and reused.[1]

Use

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Different types of bag valve masks.
The BVM directs the gas inside it via a one-way valve when compressed by a rescuer; the gas is then delivered through a mask and into the patient's trachea and into the lungs. In order to be effective, a bag valve mask must deliver between 700 and 1000 milliliters of air to the patient's lungs, but if oxygen is provided through the tubing and if the patient's chest rises with each inhalation (indicating that adequate amounts of air are reaching the lungs), 400 to 600 ml may still be adequate.[1] Squeezing the bag once every 5 seconds for an adult or once every 3 seconds for an infant or child provides an adequate respiratory rate (12 respirations per minute in an adult and 20 per minute in a child or infant).[2]

Professional rescuers are taught to ensure that the mask portion of the BVM is properly sealed around the patient's face (that is, to ensure proper "mask seal"); otherwise, air escapes from the mask and is not pushed into the lungs. In order to maintain this protocol, some protocols use a method of ventilation involving two rescuers: one rescuer to hold the mask to the patient's face with both hands and ensure a mask seal, while the other squeezes the bag.[3] However, as most ambulances have only two members of crew, the other crew member is likely to be doing compressions in the case of CPR, or may be performing other skills such as cannulation. In this case, or if no other options are available, the BVM can also be operated by a single rescuer who holds the mask to the patient's face with one hand, in the anaesthetists grip, and squeezes the bag with the other.

When using a BVM, as with other methods of insufflation, there is a risk of overinflating the lungs. This can lead to pressure damage to the lungs themselves, and can also cause air to enter the stomach, causing gastric distention which can make it more difficult to inflate the lungs and which can cause the patient to vomit. This can be avoided by care on behalf of the rescuer. Alternatively, some models of BVM are fitted with a valve which prevents overinflation, by blocking the outlet pipe when a certain pressure is reached.

An endotracheal tube (ETT) can be inserted by a trained practitioner and can substitute for the mask portion of the BVM. This provides a more secure fit and is easier to manage during emergency transport, since the ET tube is sealed with an inflatable cuff in the trachea, so that any regurgitation cannot enter the lungs. Such material can severely damage the lung tissue, and in the absence of an ET tube, could choke the patient by obstructing the airway. Inhalation of stomach contents can be fatal; the after effects can cause Mendelson's syndrome or aspiration pneumonia.

Some rescuers may also choose to use a different form of resuscitation adjunt, such as an oropharyngeal airway or Laryngeal mask airway, which would be inserted and then used with the BVM.

In a hospital, long-term mechanical ventilation is provided by using more complex devices such as an intensive care ventilator, rather than by a BVM, which requires at least one person to operate it constantly.

A flow-restricted, oxygen-powered ventilation device (FROPVD) is similar to a BVM in that oxygen is pushed through a mask into the patient's lungs, but unlike a BVM, in the FROPVD the pressure needed to push air into the patient's lungs is generated by oxygen from a tank rather than by squeezing a bag.

Ambu bag

One proprietary brand of a self-inflating BVM resuscitator, is called the ambu bag. The concept for the original ambu bag was developed in 1953 by the German engineer, Dr. Holger Hesse, and his partner, Danish anaesthatist, Henning Ruben. In 1956, the world's first non-electric, self-inflating resuscitator was ready for production by their company, Ambu A/S, which still produces a wide range of single-patient and multi-use resuscitators.

See also

References

1. ^ Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 140.
2. ^ Emergency Care, Pages 142-3
3. ^ Emergency Care, Page 141.

External links

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Health Science > Medicine > Emergency medicine, medical emergency
ProceduresAdvanced cardiac life support (ACLS) • Advanced Life Support (ALS) • Advanced Trauma Life Support (ATLS) • Basic life support (BLS) • Cardiopulmonary resuscitation (CPR) • First aid • Pediatric Advanced Life Support (PALS)
Trauma centersLevel I • Level II • Level III • Level IV
EquipmentAmbulance • Bag valve mask • Chest tube • Defibrillation (AED, ICD) • Electrocardiogram (ECG/EKG) • Intraosseous infusion (IO) • Intravenous therapy (IV) • Intubation
PeopleCertified first responder • Emergency medical technician (EMT) • Paramedic • Emergency physician • BASICS Doctor
DrugsAtropine • Epinephrine • Amiodarone • Magnesium • Bicarbonate
OtherGolden hour • Emergency department • Emergency medical services • Emergency psychiatry • Triage
Ventilation is movement of air into and outside the body, and can be used in the following contexts:
  • ventilation (architecture)
  • ventilation (firefighting)
  • ventilation (physiology)
  • ventilation (tunnel)
  • ventilation (mining)

See also


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Cardiopulmonary resuscitation (CPR) is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest.[1] CPR is performed in hospitals, or in the community by laypersons or by emergency response professionals.
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ambulance is a vehicle for transporting sick or injured people,[1]to, from or between places of treatment for an illness or injury. The term ambulance is used to describe a vehicle used to bring medical care to patients outside of the hospital and when appropriate, to
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hospital is an institution for health care, often but not always providing for longer-term patient stays. Today, hospitals are usually funded by the state, health organizations (for profit or non-profit), health insurances or charities, including direct charitable donations.
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A crash cart or code cart (crash trolley in UK medical jargon) is a set of trays on a wheeled cart that is used in hospital wards and emergency rooms. It contains all the basic equipment necessary to follow ACLS/ALS protocols and potentially save someone's life.
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Air or Earth's atmosphere is a layer of gases surrounding the planet Earth.

Air may also refer to:
  • Air (1977 video game), an air combat based mainframe computer game
  • Air (band), a French electronic music duo

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2, −1
(neutral oxide)
Electronegativity 3.44 (Pauling scale)
Ionization energies
(more) 1st: 1313.9 kJmol−1
2nd: 3388.3 kJmol−1
3rd: 5300.5 kJmol−1

Atomic radius 60 pm
Atomic radius (calc.
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Medical Emergency is an Australian reality television series screened on the Seven Network. Medical Emergency is narrated by actor Chris Gabardi who also appears in drama series All Saints.
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MeSH D012131 Respiratory failure is a medical term for inadequate gas exchange by the respiratory system. Respiratory failure can be indicated by observing a drop in blood oxygen level (hypoxemia) and/or a rise in arterial carbon dioxide (hypercapnia) which can be written as
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Respiratory arrest
Classifications and external resources

ICD-10 R 09.2
ICD-9 799.1

Respiratory arrest is the cessation of the normal tidal flow of the lungs due to paralysis of the diaphragm, collapse of the lung or any number of respiratory
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mechanical ventilation is a method to mechanically assist or replace spontaneous breathing when patients cannot do so on their own, and must be done so after invasive intubation with an endotracheal or tracheostomy tube through which air is directly delivered (in contrast to
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Exhalation (or expiration) is the movement of air out of the bronchial tubes, through the airways, to the external environment during breathing.

Exhaled air is rich in carbon dioxide, a waste product of cellular respiration during the production of ATP.
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Disinfectants are antimicrobial agents that are applied to non-living objects to destroy microorganisms, the process of which is known as disinfection. Disinfectants should generally be distinguished from antibiotics
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valve is a device that regulates the flow of substances (either gases, fluidized solids, slurries, or liquids) by opening, closing, or partially obstructing various passageways. Valves are technically pipe fittings, but usually are discussed separately.
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trachea, or windpipe, is a tube that has an inner diameter of about 20-25 mm and a length of about 10-16cm. It extends from the larynx to the primary (main) bronchi in mammals, and from the pharynx to the syrinx in birds, allowing the passage of air to the lungs.
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lungs flank the heart and great vessels in the chest cavity.[1]]]

The lung is the essential respiration organ in air-breathing vertebrates, the most primitive being the lungfish.
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The litre or liter (see spelling differences) is a unit of volume. There are two official symbols, namely the Latin letter L both in lower and upper case: l and L.
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respiratory rate (or respiration rate) is the number of breaths a living being, such as a human, takes per minute.

There is only limited research on monitoring alien respiratory rate, and these studies have focused on such issues as the inaccuracy of respiratory rate
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ambulance is a vehicle for transporting sick or injured people,[1]to, from or between places of treatment for an illness or injury. The term ambulance is used to describe a vehicle used to bring medical care to patients outside of the hospital and when appropriate, to
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A cannula (from Latin "little reed"; plural cannulae) is a flexible tube which when inserted into the body is used either to withdraw fluid or insert medication.
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An anesthesiologist (American English), or anaesthetist (British English), also "anaesthesiologist," is a medical doctor trained to administer anesthesia and manage the medical care of patients before, during, and after surgery.
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Gastric distention is bloating of the stomach when air is pumped into it. This may be done when someone is performing cardiopulmonary resuscitation and blowing air into the mouth of someone who is not breathing spontaneously.
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Emesis redirects here. For the genus of metalmark butterflies, see Emesis (butterfly). Heaving redirects here. For the up-and-down motion, see heave.

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endotracheal tube (also called an ET tube or ETT) is used in anaesthesia, intensive care and emergency medicine for airway management and mechanical ventilation.
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Regurgitation is the controlled flow of stomach contents back into the esophagus and mouth.

Regurgitation is used by a number of species to feed their young. This is typically in circumstances where the young is at a fixed location and a parent must forage or hunt for food,
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lungs flank the heart and great vessels in the chest cavity.[1]]]

The lung is the essential respiration organ in air-breathing vertebrates, the most primitive being the lungfish.
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Choking
Classification & external resources

ICD-10 F41.0, R06.8, T17, W78-W80
ICD-9 784.9 , 933.1

For choking meaning compression of the neck, see Strangling. For other usage of choking, see choke.

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Mendelson's syndrome is chemical pneumonia caused by aspiration during anaesthesia, especially during pregnancy.

External links

  • synd/2330 at Who Named It


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Aspiration pneumonia
Classification & external resources

Histopathologic image of aspiration pneumonia in an elderly patient with debilitating neurologic illness. Note foreign-body giant cell reaction. Autopsy case. H & E stain.
ICD-10 J 69.0 , P 24.
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An oropharyngeal airway (also known as an oral airway,OPA or Guedal pattern airway) is a medical device called an airway adjunct used to maintain a patent (open) airway.
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