1 / 15

BAG & MASK VENTILATION

BAG & MASK VENTILATION. Indications. Apneic or gasping following initial steps and tactile stimuloation HR<100/min in a spontaneously breathing baby Spontaneously breathing infant - cyanotic despite free flow oxygen. Contraindications. Diaphragmatic hernia

zeus-albert
Télécharger la présentation

BAG & MASK VENTILATION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. BAG & MASK VENTILATION

  2. Indications • Apneic or gasping following initial steps and tactile stimuloation • HR<100/min in a spontaneously breathing baby • Spontaneously breathing infant - cyanotic despite free flow oxygen

  3. Contraindications • Diaphragmatic hernia • Non -vigorous baby born through meconium stained liquor

  4. Selecting bag & mask equipment • Size of bag (240-750 ml): To deliver a tidal volume of 6-8 ml/kg • Oxygen capability: Oxygen source, reservoir • Safety feature: Pop off valve, pressure gauge (optional) • Mask: Size 0 & 1 (Cover chin, mouth, nose), cushioned edges

  5. Forming seal • Positioning the infant • Position of resuscitator

  6. Forming & checking the seal • Positioning & holding the mask: Enclose chin, mouth & nose, ensure snug seal, avoid pressure over neck and eyes • Squeeze the bag with finger tips: Don’t squeeze empty the bag with whole hand • Observe chest movements: Noticeable rise and fall of chest, shallow and easy breathing

  7. Ventilation rate and pressure • Rate : 40-60 breaths/minute Squeeze-two-three-squeeze • Pressure : Increase in HR &/or Noticeable rise and fall of chest Initial breath: 30-40 cms H2O Later : 15-20 cms H2O

  8. Improvement • Increasing HR • Improving color • Spontaneous breathing

  9. No improvement / deterioration • Chest movement not adequate • Inadequate seal • Reapply mask • Blocked airway • Reposition • Clear secretions • Ventilate with open mouth • Insufficient pressure • Increasing pressure

  10. Deterioration • Check oxygen delivery system • Oxygen supply • Oxygen tubing

  11. Orogastric catheter • Indication • Need for bag and mask ventilation for over 2 minutes • Technique • Use 6-8 Fr size, measure the length, aspirate gastric contents, leave outer end open

  12. Preterm infants • Avoid excessive chest wall movements (large tidal volume) • Monitoring of pressure may help to provide consistent inflations and avoiding unnecessary high pressure • CPAP after resuscitation may be helpful

  13. Select bag and connect to oxygen source • capable of giving 100% oxygen • Select appropriate size mask • Test bag • Good pressure • Pressure release valve working • Pressure manometer 30-40 cm H2O Baby needs Bag and mask ventilation • Position yourself at head end or side of baby • Position baby’s head in sniffing position • Position bag and mask properly on baby • Check easy chest rise during first two-three breaths

  14. Bag and mask ventilation Chest Rise No Yes Check for inadequate seal; reapply face mask Yes Chest Rise No Check forblocked airway. Reposition head, remove secretions, mouth slightly open Yes Chest Rise No Consider insufficient pressure. Increase pressure; consider intubation

  15. Ventilate for 30 seconds Rate 40-60 bpm Increasing HR, visible rise and fall of chest Check heart rate with stethoscope or umbilical palpation for 6 seconds Less than 6 beats (< 60bpm) 6-10 beats (60-100bpm) More than 10 beats (>100 bpm) • Continue ventilation • Initiate chest compression • Consider intubation • Continue ventilation • Consider intubation • Check for • spontaneous • breathing Yes No • Gradually discontinue • positive pressure ventilation • Provide tactile stimulation • Provide free flow oxygen • Need of post-resuscitation care • Continue positive pressure ventilation • Consider intubation • Consider OG tube insertion • Need of post-resuscitation care

More Related