Mask ventilation

OBJECTIVE: Providing adequate bag-mask ventilation (BMV) is an essential skill for neonatal resuscitation. Often this skill is learned using simulation manikins. Currently, there is no means of measuring the adequacy of ventilation in simulated scenarios. Thus, it is not possible to ascertain proficiency. The first aim of this study was to measure the pressure generated during BMV as performed by providers with different skill levels and measure the impact of different feedback mechanisms...

Mask ventilation is lifesaving, especially in cases of difficult intubation. Many publications have offered distinct techniques for optimizing mask ventilation. This article reviews currently available difficult mask ventilation literature and theory. We divide difficult mask ventilation into 3 broad categories based on etiology: inadequate mask seal, increased airway resistance, and decreased respiratory compliance. Published strategies for overcoming difficulty are presented and organized by etiology.

AIM: Approximately 20% of newborns infants need respiratory support at birth. This study evaluated whether video-based education could improve quality of positive pressure ventilation (PPV) performed by inexperienced staff during neonatal resuscitation. METHODS: Fourth-year medical students were randomly paired and instructed to give PPV to a modified manikin as single-person resuscitators and as two-person-paired resuscitators using either an air cushion rim mask or a round mask before and after watching a self-instructional video...

BACKGROUND: Delivery room cardiopulmonary resuscitation is rare. Recent evidence suggests that effective ventilation may be compromised during chest compressions (CC). OBJECTIVES: To determine whether trained neonatal personnel can assess effective ventilation during CC in the setting of changing lung compliance. METHODS: Neonatal providers (n=30) provided CC using a 3:1 CC to ventilation ratio performed for 2 min, with lung compliance adjusted every 30 s from 0...

INTRODUCTION: Increasedlife expectancy in populations has brought along specific new scenarios in the fields of medicine for the elderly; prevalence of physical complications such as edentulism and patients with dentures is growing. Management of anesthesia and ventilation in this group of patients has turned into a great challenge. Some researchers suggest dentures to be left in place during bag-mask ventilation; yet, no unanimous agreement exists in this regard. METHODS: In a single blind randomized clinical trial, we studied 300 patients with ASA class I, II (American Society of Anesthesiologists), Mallampati class (I, II) and aged over 55 years in three groups...

BACKGROUND: This study aimed to determine the accuracy of commonly used preoperative difficult airway indices as predictors of difficult mask ventilation (DMV) in obese patients (BMI >30 kg/m2). METHODS: In 309 consecutive obese patients undergoing general surgery, the modified Mallampati test, patient's Height/Thyromental distance ratio, Inter-Incisor Distance, Protruding Mandible (PM), history of Obstructive Sleep Apnea and Neck Circumference (NC) were recorded preoperatively...

OBJECTIVE: To investigate if external chest compressions (ECC) increase mask leak, and if human or technical feedback improves mask ventilation during simulated neonatal cardiopulmonary resuscitation (CPR). STUDY DESIGN: In this observational study, 32 participants delivered positive pressure ventilation (PPV) to a modified, leak-free manikin via facemask. Mask leak, tidal volume (VT), positive end expiratory pressure (PEEP) and respiratory rate (RR) were measured with a respiratory function monitor (RFM)...

BACKGROUND: Different face mask designs can influence bag-valve-mask (BVM) ventilation performance during resuscitation. We compared a single-use, air-cushioned face mask (AM) with a reusable silicone face mask (SM) for quality of BVM ventilation on a manikin simulating cardiac arrest. METHODS: Thirty-two physicians were recruited, and a prospective, randomized, crossover observational study was conducted after an American Heart Association-accredited basic life support provider course and standardized practice time were completed...

BACKGROUND: To compare a novel, pressure-limited, flow adaptive ventilator that enables manual triggering of ventilations (MEDUMAT Easy CPR, Weinmann, Germany) with a bag-valve-mask (BVM) device during simulated cardiac arrest. METHODS: Overall 74 third-year medical students received brief video instructions (BVM: 57s, ventilator: 126s), standardised theoretical instructions and practical training for both devices. Four days later, the students were randomised into 37 two-rescuer teams and were asked to perform 8min of cardiopulmonary resuscitation (CPR) on a manikin using either the ventilator or the BVM (randomisation list)...

AIM: The quality of cardiopulmonary resuscitation (CPR) is a crucial determinant of outcome following cardiac arrest. Interruptions in chest compressions are detrimental. We aimed to compare the effect of mouth-to-mouth ventilation (MMV), mouth-to-pocket mask ventilation (MPV) and bag-valve-mask ventilation (BMV) on the quality of CPR. MATERIALS AND METHODS: Surf lifeguards in active service were included in the study. Each surf lifeguard was randomized to perform three sessions of single-rescuer CPR using each of the three ventilation techniques (MMV, MPV and BMV) separated by 5 min of rest...

BACKGROUND: Mask ventilation is considered a "basic" skill for airway management. A one-handed "EC-clamp" technique is most often used after induction of anesthesia with a two-handed jaw-thrust technique reserved for difficult cases. Our aim was to directly compare both techniques with the primary outcome of air exchange in the lungs. METHODS: Forty-two elective surgical patients were mask-ventilated after induction of anesthesia by using a one-handed "EC-clamp" technique and a two-handed jaw-thrust technique during pressure-control ventilation in randomized, crossover fashion...

PURPOSE: We sought to compare the ability of novice operators to provide artificial ventilation using a standard facemask and a new ergonomically designed facemask. Whether or not proper technique was used was also assessed. METHODS: Thirty-two allied-health students used both masks in random crossover fashion to ventilate an airway trainer. Breaths were delivered by a mechanical ventilator and exhaled tidal volume was recorded for each of 12 breaths for each participant for each mask...

Mask ventilation is the most fundamental skill in airway management. In this review, we summarize the current knowledge about difficult mask ventilation (DMV) situations. Various definitions for DMV have been used in the literature. The lack of a precise standard definition creates a problem for studies on DMV and causes confusion in data communication and comparisons. DMV develops because of multiple factors that are technique related and/or airway related. Frequently, the pathogenesis involves a combination of these factors interacting to cause the final clinical picture...

BACKGROUND: There are no existing data regarding risk factors for impossible mask ventilation and limited data regarding its incidence. The authors sought to determine the incidence, predictors, and outcomes associated with impossible mask ventilation. METHODS: The authors performed an observational study over a 4-yr period. For each adult patient undergoing a general anesthetic, preoperative patient characteristics, detailed airway physical exam, and airway outcome data were collected...

BACKGROUND: Mask ventilation is an essential element of airway management that has rarely been studied as the primary outcome. The authors sought to determine the incidence and predictors of difficult and impossible mask ventilation. METHODS: A four-point scale to grade difficulty in performing mask ventilation (MV) is used at the authors' institution. They used a prospective, observational study to identify cases of grade 3 MV (inadequate, unstable, or requiring two providers), grade 4 MV (impossible to ventilate), and difficult intubation...

Tracheal intubation (ETI) is considered the method of choice for securing the airway and for providing effective ventilation during cardiac arrest. However, ETI requires skills which are difficult to maintain especially if practised infrequently. The laryngeal tube (LT) has been successfully tested and used in anaesthesia and in simulated cardiac arrest in manikins. To compare the initiation and success of ventilation with the LT, ETI and bag-valve mask (BVM) in a cardiac arrest scenario, 60 fire-fighter emergency medical technician (EMT) students formed teams of two rescuers at random and were allocated to use these devices...

This study suggests that the bag-valve-mask (BVM) used by a single rescuer with minimal training fails to deliver adequate tidal volumes for resuscitation. When two rescuers use the BVM, tidal volumes are more than recommended and are comparable to those seen with endotracheal intubation. Two-person BVM ventilation should be considered for initial resuscitation in cardiopulmonary arrest.