Mask ventilation
This procedure is useful during
resuscitation or for short periods of as-sisted ventilation. It can be
performed using a self-inflating bag and face mask with an appropriately-sized
reservoir bag; alternatively, use a mask connected to a ‘T’ piece and a
continuous supply of gas, as well as a pressure-limiting device. In the latter,
a breath is given by occluding the open aperture of the ‘T’ piece.
•
Ensure
patent airway.
•
Select
appropriate size mask. It should be big enough to be able to cover the face
from the bridge of the nose to below the mouth, but not extend over the edge of
the chin or over the orbits. In infants a round mask, e.g. Laerdal® or Bennett’s mask, is most appropriate. In
older children the Laerdal®
moulded mask is more suitable.
•
Connect
face mask to an appropriate self-inflating bag or tubing with a ‘T’ piece and
then to an oxygen or air supply at an adequate flow rate, e.g. 5–8L/min in the
newborn.
•
In newborns,
a pressure-limiting valve should used and initially be set at 725–30cmH2O.
•
Apply
mask to face over mouth and nose, and apply enough downward pressure to make an
effective seal.
•
Give
inflation breaths by either compressing self-inflating bag or occluding open
aperture of ‘T’ piece.
•
Observe
and ausculate chest wall for adequate inflation. Note whether condition of
child is improving or deteriorating.
•
If
inflation is poor or child deteriorating, check airway is not obstructed and
use one or more techniques to ensure patent airway.
Prolonged mask ventilation is
likely to lead to a distended stomach. Insert an oro-gastric tube on free
drainage to decompress the stomach and pre-vent diaphragmatic splinting.
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