Delivering breaths through bag-mask ventilation: How it works
In emergency situations, Bag Mask Ventilation (BMV) plays a crucial role in providing a rapid supply of oxygen to individuals experiencing various respiratory distress. This technique, often used in cases of hypercapnic respiratory failure, hypoxic respiratory failure, apnea, airway illness, or before certain scheduled surgeries, involves a healthcare professional manually pumping oxygen into a person's lungs using a bag valve mask.
The process is simple yet effective: the medical professional squeezes the self-inflating bag to push oxygen into the lungs. The equipment used includes a self-inflating bag, mask, oxygen source, oxygen tubing, PEEP valve, and tubes to hold airways open. A PEEP valve can be attached to the bag valve mask to help maintain pressure inside the lungs.
However, like any medical procedure, BMV comes with potential complications. The primary concern is gastric insufflation, where air inadvertently enters the stomach, potentially causing gastric distention. If this occurs, a nasogastric tube should be inserted to evacuate the air and prevent further complications such as aspiration.
Other complications, more generally associated with positive pressure ventilation (though more common with mechanical ventilation rather than manual BMV), include barotrauma, volutrauma, pneumothorax, and ventilator-associated lung injury; however, these are less typical for short-term BMV use.
To minimize these risks, certain precautions are essential. Proper technique to ensure an effective mask seal and avoid excessive ventilation pressure or volume is vital to reduce the risk of gastric insufflation. The use of appropriate equipment such as oropharyngeal or nasopharyngeal airways to maintain patency of the airway is also crucial.
Employing universal precautions, including gloves, gown, and eye protection, is necessary to prevent infection spread. Monitoring oxygenation (pulse oximeter) and ventilation effectiveness (capnometer where available) is essential. Prolonged use of BMV should be avoided when possible, as it increases the risk of complications.
If gastric distention is observed, nasogastric tube insertion is recommended to decompress the stomach. Inexperience with BMV technique can reduce effectiveness and increase complications such as inadequate ventilation or air leakage. Therefore, proper training and experience are important precautions to ensure safe and effective BMV.
Research from 2019 found that critically ill people receiving BMV alongside tracheal intubation had higher oxygen saturation levels and lower rates of severely low oxygen levels. Despite its potential complications, when used correctly, BMV can be a successful ventilation technique.
It's important to note that certain factors can make BMV more difficult for a healthcare professional. These include people who have obesity, are older adults, have no teeth, have beards, are snoring, or are stiff.
In conclusion, while Bag Mask Ventilation is a lifesaving technique, it requires proper technique, airway management, universal precautions, and monitoring to minimize risks. With the right approach, BMV can make a significant difference in critical situations.
[1] Respiratory Care. (2019). Bag-Mask Ventilation. Retrieved from https://www.rcjournal.com/article/S0149-8001(19)30159-7/fulltext [2] American Journal of Emergency Medicine. (2018). Bag-Mask Ventilation Skills Training: A Systematic Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152735/ [3] Critical Care Medicine. (2012). Barotrauma and volutrauma in mechanical ventilation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406639/
- In the field of health and wellness, it's crucial to understand the importance of respiratory conditions, especially during critical medical-conditions such as respiratory distress, for which Bag Mask Ventilation (BMV) can be a valuable treatment option.
- Other respiratory conditions, like hypercapnic and hypoxic respiratory failure, apnea, airway illness, can also benefit from BMV when used correctly, demonstrating the broad application of this technique in the science of medicine.
- The effectiveness of BMV, as a lifesaving tool, can be enhanced through proper training, experience, and adherence to universal precautions to minimize potential complications, such as gastric insufflation, gastric distention, barotrauma, volutrauma, pneumothorax, and ventilator-associated lung injury.
