POCKET FACE MASK

Limitations of the Bag-Valve Mask Ventilator The bag-valve mask ventilator is difficult to use unless the user has had sufficient practice with it. It must not be used by inexperienced individuals. The system can be hard to clean and reassemble properly; the bagging hand can tire easily; and an airtight seal at the face is hard to maintain, especially if a single rescuer must also keep the airway open. In addition, the amount of air delivered to the victim is limited to the volume that the hand can displace from the bag (approximately 1 liter per compression). Procedures for Operating the Bag-Valve Mask Ventilator To use the bag-valve mask ventilator, hook the bag up to an oxygen supply and adjust the flow in the range of 10 to 15 liters per minute, depending on the desired concentration (15 liters per minute will deliver an oxygen concentration of 90 percent). After opening the airway or inserting an oropharyngeal airway, place the mask over the face and hold it firmly in position with the index finger and thumb, while keeping the jaw tilted upward with the remaining fingers (fig. 4-23). Use the other hand to compress the bag once every 5 seconds. Observe the chest for expansion. If none is observed, the face mask seal may not be airtight, the airway may be blocked, or some component of the bag-valve mask ventilator may be malfunctioning. POCKET FACE MASK A pocket face mask designed with an oxygen-inlet flow valve for mouth-to-mask ventilation can be used to give oxygen-enriched artificial ventilation. Although a pocket face mask system cannot achieve oxygen concentrations as high as the bag-valve mask system, it has the advantages of providing greater air volume (up to 4 liters per breath) and of being much easier to use (since both hands are free to maintain the airway and keep the mask firmly in place). See figure 4-24. The pocket face mask also acts as a barrier device. It prevents the rescuer from coming in contact with the patient’s body fluids and breath, which are possible sources of infection. To use the pocket face mask, stand behind the head of the victim, and open the airway by tilting the head backward. Place the mask over the victim’s face (for adults, the apex goes over the bridge of the nose; for infants, the apex fits over the chin, with the base resting on the bridge of the nose). Form an airtight seal between the mask and the face, and keep the airway open by pressing down on the mask with both thumbs while using the other fingers to lift the jaw up and back. Ventilate into the open chimney of the mask. 4-27 Figure 4-23.—Bag-valve mask ventilator in use. Figure 4-24.—Providing mouth-to-mask ventilations with pocket face mask.