Bag-valve mask ventilation

• C-E hold
  • Chest rise
  • Delivery of blow-by oxygen with ambu-bag
  • 2-person bagging
  • Oropharyngeal airways
  • Nasopharyngeal airways

Contraindications: complete airway obstruction, spontaneously breathing patient

Complications: barotrauma, gastric distention

Procedure for bag-valve mask ventilation:

• Adjust bed height to provider
• Ensure proper face mask size and fit (should cover mouth and nose)
• Clear mouth and face of secretions
• Place patient in sniffing position; perform chin lift/jaw thrust
• When possible, employ another team member to do 2-person bagging, where one person secures mask with tight seal (2 hands), and the other delivers breaths

Airway Adjuncts

Oropharyngeal Airway:

• Unconscious patient with NO gag reflex
• Size: earlobe to corner of mouth
• Insertion: tongue depressor and insert (younger) OR sideways/upside down and then turn (older)

Nasopharyngeal airway:

• Upper airway obstructed patient with/without gag/consciousness (eg seizure)
• Contraindications: head/neck injury, basilar skull fracture,
• Size: earlobe to nostril
• Insertion: lubricate and insert