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Bag Mask Ventilation

Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
Sophie J E Cramer, Janneke Dekker, Jenny Dankelman, Steffen C Pauws, Stuart B Hooper, Arjan B Te Pas
Apnea of prematurity (AOP) is one of the most common diagnoses in preterm infants. Severe and recurrent apneas are associated with cerebral injury and adverse neurodevelopmental outcome. Despite pharmacotherapy and respiratory support to prevent apneas, a proportion of infants continue to have apneas and often need tactile stimulation, mask, and bag ventilation and/or extra oxygen. The duration of the apnea and the concomitant hypoxia and bradycardia depends on the response time of the nurse. We systematically reviewed the literature with the aim of providing an overview of what is known about the effect of manual and mechanical tactile stimulation on AOP...
2018: Frontiers in Pediatrics
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
Mosarrat J Qureshi, Manoj Kumar
BACKGROUND: Providing effective positive pressure ventilation is considered to be the single most important component of successful neonatal resuscitation. Ventilation is frequently initiated manually with bag and face mask (BMV) followed by endotracheal intubation if respiratory depression continues. These techniques may be difficult to perform successfully resulting in prolonged resuscitation or neonatal asphyxia. The laryngeal mask airway (LMA) may achieve initial ventilation and successful resuscitation faster than a bag-mask device or endotracheal intubation...
March 15, 2018: Cochrane Database of Systematic Reviews
Justine Dol, Marsha Campbell-Yeo, Gail Tomblin Murphy, Megan Aston, Douglas McMillan, Brianna Richardson
OBJECTIVE: The objective of this review was to evaluate the impact of the Helping Babies Survive program on neonatal outcomes and healthcare provider knowledge and skills. INTRODUCTION: The Helping Babies Survive program consists of three modules: Helping Babies Breathe, Essential Care for Every Baby, and Essential Care for Small Babies. It was developed to reduce preventable newborn deaths through skill-based learning using simulation, learning exercises, and peer-to-peer training of healthcare providers in low-resource areas...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
Gemma Malpas, Orlando Hung, Ainslie Gilchrist, Chrison Wong, Blaine Kent, Gregory M Hirsch, Robert D Hart
While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management...
March 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Patricia Jabre, Andrea Penaloza, David Pinero, Francois-Xavier Duchateau, Stephen W Borron, Francois Javaudin, Olivier Richard, Diane de Longueville, Guillem Bouilleau, Marie-Laure Devaud, Matthieu Heidet, Caroline Lejeune, Sophie Fauroux, Jean-Luc Greingor, Alessandro Manara, Jean-Christophe Hubert, Bertrand Guihard, Olivier Vermylen, Pascale Lievens, Yannick Auffret, Celine Maisondieu, Stephanie Huet, Benoît Claessens, Frederic Lapostolle, Nicolas Javaud, Paul-Georges Reuter, Elinor Baker, Eric Vicaut, Frédéric Adnet
Importance: Bag-mask ventilation (BMV) is a less complex technique than endotracheal intubation (ETI) for airway management during the advanced cardiac life support phase of cardiopulmonary resuscitation of patients with out-of-hospital cardiorespiratory arrest. It has been reported as superior in terms of survival. Objectives: To assess noninferiority of BMV vs ETI for advanced airway management with regard to survival with favorable neurological function at day 28...
February 27, 2018: JAMA: the Journal of the American Medical Association
Myriam Santos-Folgar, Martín Otero-Agra, Felipe Fernández-Méndez, María Teresa Hermo-Gonzalo, Roberto Barcala-Furelos, Antonio Rodríguez-Núñez
INTRODUCTION: It has been observed that health professionals have difficulty performing quality cardiopulmonary resuscitation (CPR). The aim of this study was to compare the quality of ventilations performed by Nursing students on an infant model using different methods (mouth-to-mouth-and-nose or bag-valve-mask). MATERIAL AND METHODS: A quasi-experimental cross-sectional study was performed that included 46 second-year Nursing students. Two quantitative 4-minute tests of paediatric CPR were performed: a) mouth-to-mouth-and-nose ventilations, and b) ventilations with bag-valve-mask...
February 8, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: To assess the placement, surveillance management and long-term outcomes of the tracheobronchial (TB) balloon expandable metallic stent (BEMS) managed by therapeutic flexible endoscopy (TFE). METHODS: This is a retrospective review and analysis of all computerized medical records and related flexible endoscopy videos of pediatric patients who received TB BEMS during 20 years period, from January 1997 to December 2016. TFE techniques with forceps debridement, balloon dilatation and laser ablation were used to implant stents, perform regular surveillance, maintain their functions, and expand the diameters of BEMS...
2018: PloS One
C Baillard, G Prat, B Jung, E Futier, J Y Lefrant, F Vincent, A Hamdi, E Vicaut, S Jaber
BACKGROUND: Previous data showed that non-invasive ventilation (NIV) applied for 3 min before tracheal intubation ensured better oxygenation compared with using a non-rebreather bag-valve-mask. We aimed to determine whether preoxygenation using NIV is effective in reducing the incidence of organ dysfunction in hypoxaemic, critically ill patients in intensive care. METHODS: A multicentre, randomised, open-label trial evaluating 100% FiO2 administered with NIV (99 patients) vs with face mask (102 patients) for 3 min before tracheal intubation...
February 2018: British Journal of Anaesthesia
Battu Kumar Shrestha, Apurb Sharma, Parbesh Kumar Gyawali
BACKGROUND: Common airway management strategies during cardiopulmonary resuscitation are bag- mask-valve ventilation followed by endotracheal intubation. Timing of endotracheal intubation is controversial. This study was designed to compare the effect of early vs late endotracheal intubation in terms of return of spontaneous circulation. METHODS: This is an observational retrospective study done at tertiary center for the period of two years. The study population was inpatient, adult and pediatric with witnessed cardiac arrest in whom airway management was initially done with bag-valve-mask ventilation followed by endotracheal intubation...
January 1, 2018: Journal of Nepal Health Research Council
R Moshiro, H L Ersdal, P Mdoe, H L Kidanto, C Mbekenga
BACKGROUND: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. OBJECTIVE: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania...
2018: Global Health Action
Matthew T V Chan, Benny K Chow, Thomas Lo, Fanny W Ko, Susanna S Ng, Tony Gin, David S Hui
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles...
January 9, 2018: Scientific Reports
Monika Bajaj, Girija Natarajan, Seetha Shankaran, Myra Wyckoff, Abbot R Laptook, Edward F Bell, Barbara J Stoll, Waldemar A Carlo, Betty R Vohr, Shampa Saha, Krisa P Van Meurs, Pablo J Sanchez, Carl T D'Angio, Rosemary D Higgins, Abhik Das, Nancy Newman, Michele C Walsh
OBJECTIVES: To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. STUDY DESIGN: This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use...
January 3, 2018: Journal of Pediatrics
Sophie Janet, Verena I Carrara, Julie A Simpson, Nant War War Thin, Wah Wah Say, Naw Ta Mlar Paw, Kesinee Chotivanich, Claudia Turner, Jane Crawley, Rose McGready
BACKGROUND: Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. METHODS: Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border...
2018: PloS One
Rasmus Aagaard, Bo Løfgren, Thorbjørn Grøfte, Erik Sloth, Roni R Nielsen, Christian A Frederiksen, Asger Granfeldt, Morten T Bøtker
INTRODUCTION: Focused cardiac ultrasound can potentially identify reversible causes of cardiac arrest during advanced life support (ALS), but data on the timing of image acquisition are lacking. This study aimed to compare the quality of images obtained during rhythm analysis, bag-mask ventilations, and chest compressions. METHODS: Adult patients in cardiac arrest were prospectively included during 23 months at a Danish community hospital. Physicians who had completed basic ultrasound training performed subcostal focused cardiac ultrasound during rhythm analysis, bag-mask ventilations, and chest compressions...
December 12, 2017: Resuscitation
Clayton P Josephy, David R Vinson
OBJECTIVE: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. We report our experience on the feasibility of replacing a two-physician ED procedural sedation policy with a single-physician policy in a small, single-coverage community ED. METHODS: This is a retrospective, before/after, single-center observational study of prospectively collected data from January 2013 through December 2016...
November 3, 2017: American Journal of Emergency Medicine
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
Background: Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care during neonatal resuscitation (NR) can contribute to a reduction in neonatal mortality related to birth asphyxia by 30 percent. This study assessed the quality of care (QoC) during NR for newborns with birth asphyxia. Methods: Direct observations of 138 newborn resuscitations were done in labor ward and maternity theatre. Twenty-eight healthcare providers were observed 3-5 times using a structured checklist...
2017: BioMed Research International
Joel M Mumma, Francis T Durso, Michelle Dyes, Rogelio Dela Cruz, Valerie P Fox, Mary Hoey
Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Background BVMV is a common and critical procedure for managing pediatric respiratory emergencies. However, providers do not consistently deliver effective BVMV. Efforts to improve BVMV have ignored the question of how providers effectively use feedback often available during BVMV...
March 2018: Human Factors
Anthony Richard Rafferty, Lucy Johnson, Peter G Davis, Jennifer Anne Dawson, Marta Thio, Louise S Owen
OBJECTIVE: Neonatal mask ventilation is a difficult skill to acquire and maintain. Mask leak is common and can lead to ineffective ventilation. The aim of this study was to determine whether newly available neonatal self-inflating bags and masks could reduce mask leak without additional load being applied to the face. DESIGN: Forty operators delivered 1 min episodes of mask ventilation to a mannequin using the Laerdal Upright Resuscitator, a standard Laerdal infant resuscitator (Laerdal Medical) and a T-Piece Resuscitator (Neopuff), using both the Laerdal snap-fit face mask and the standard Laerdal size 0/1 face mask (equivalent sizes)...
November 30, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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