Abstract
Manual ventilation is a basic skill that involves airway assessment, maneuvers to open the airway, and application of simple and complex airway support devices and effective positive-pressure ventilation using a bag and mask. An important part of manual ventilation is recognizing its success and when it is difficult or impossible and a higher level of support is necessary to sustain life. Careful airway assessment will help clinicians identify what and when the next step needs to be taken. Often simple airway maneuvers such as the head tilt/chin lift and jaw thrust can achieve a patent airway. Appropriate use of airway adjuncts can further aid the clinician in situations in which airway maneuvers may not be sufficient. Bag-mask ventilation (BMV) plays a vital role in effective manual ventilation, improving both oxygenation and ventilation as well as buying time while preparations are made for endotracheal intubation. There are, however, situations in which BMV may be difficult or impossible. Anticipation and early recognition of these situations allows clinicians to quickly make adjustments to the method of BMV or to employ a more advanced intervention to avoid delays in establishing adequate oxygenation and ventilation.
- spontaneous ventilation
- airway assessment
- head position
- head tilt/chin lift
- jaw thrust
- cervical spine immobilization
- cricoid pressure
- oropharyngeal airway
- nasopharyngeal airway
- bag-mask ventilation
- difficult mask ventilation
Footnotes
- Correspondence: John D Davies MA RRT FAARC, Respiratory Care Services, Duke University Hospital, Box 3911 Duke North, Erwin Road, Durham, NC 27710. E-mail: john.davies{at}duke.edu.
Mr Davies serves on an advisory board for Philips Healthcare and is a clinical consultant for Teleflex Medical. Mr Costa and Mr Asciutto have disclosed no conflicts of interest.
Mr Davies presented a version of this paper at the 52nd Respiratory Care Journal Conference, “Adult Artificial Airways and Airway Adjuncts,” held June 14 and 15, 2013, in St Petersburg, Florida.
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