The role of face-mask ventilation in emergency situations is rapidly diminishing. I believe the first response to hypoxia should always be Os up the nose, either a standard nasal cannula combined with a non-rebreather to get flows >30 lpm or special high-flow, warm, humidified nasal cannula systems. Sit the patient upright as much as possible and pull on the mandible. In cardiac arrest, passive oxygenation and an LMA-type device should be used preferentially over bagging a patient in a flat position. If you have to use a face mask to provide PEEP (ie, BVM with a PEEP valve or continuous positive airway pressure mask), always do so in an upright position.
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ACEP Now: Vol 36 – No 01 – January 2017Pages: 1 2 3 4 | Single Page
3 Responses to “Should Emergency Physicians Abandon Face-Mask Ventilation?”
January 30, 2017
Jose Dionisio Torres, Jr., MDWhat do we have is cost and demand? And the illusion of patient safety.
The public doesn’t know the difference from a bvm..and and lma/or king lt.
These devices are better in ventilation than bvm. But need the bvm if there is a contraindication.
Facemask cheaper but ensures air will go into the stomach ensuring higher risk of aspiration. But don’t use in Coffin position described by you Dr. Levitan. Ramp them up as high as possible if bvm is to be used.
Thank you for the Post Dr. Levitan.
Thank you Mr. Robert Ackerman on sharing this post with me.
March 5, 2017
Craig NavarijoI believe the bvm can be made much more safely than it is today…
in fact, I have working protoypes of a bvm that an individual can selectivley limit volume delivery with.
and that makes maintaining a seal extremely easy ….
March 6, 2017
Steve LeCroyDr. Levitan,
Would you consider using one or two NPA’s like naso-flo that can provide supplemental oxygen along with CPAP instead of a cannula and non-rebreather mask?