WEBVTT 1 00:00:02.055 --> 00:00:07.021 Alright, so let's take a look at the bag valve mask a bit closer. 2 00:00:07.021 --> 00:00:11.055 Professional rescuers are encouraged to use the bag valve mask whenever possible 3 00:00:11.055 --> 00:00:14.066 but one important aspect of this is that it takes practice. 4 00:00:14.066 --> 00:00:17.016 It's not that it's rocket science at all, 5 00:00:17.016 --> 00:00:21.035 but it just takes practice to be able to get your fingers placed correctly 6 00:00:21.035 --> 00:00:25.017 and to get your own technique down with some of the hints I'm going to show you 7 00:00:25.017 --> 00:00:28.062 to be able to seal the mask to the face of the patient. 8 00:00:28.062 --> 00:00:31.029 Another mistake that's commonly made is we think 9 00:00:31.029 --> 00:00:34.057 we're going to crush the mask down onto the face of the patient. 10 00:00:34.057 --> 00:00:36.090 When in reality, we're sealing it, 11 00:00:36.090 --> 00:00:41.069 but bringing the face of the patient up into the mask. 12 00:00:41.069 --> 00:00:43.078 Not mask down on patient's face. 13 00:00:43.078 --> 00:00:46.052 Face up into mask. 14 00:00:46.052 --> 00:00:52.008 That combined with sealing with the C-E method 15 00:00:52.008 --> 00:00:54.071 allows us usually to get a pretty good seal. 16 00:00:54.071 --> 00:00:57.036 Some of the reasons you might not get a good seal 17 00:00:57.036 --> 00:01:02.070 is deformity to the face, traumatic injury to the face, or a lot of facial hair. 18 00:01:02.070 --> 00:01:05.026 If that happens, you're going to do the best you can, 19 00:01:05.026 --> 00:01:08.064 but it's probably going to be an intubation patient at that point 20 00:01:08.064 --> 00:01:10.031 to be able to control the airway. 21 00:01:10.031 --> 00:01:14.069 But for this case, we're talking about basic life support with a bag valve mask. 22 00:01:14.069 --> 00:01:17.031 Notice, I've taken the reservoir bag off. 23 00:01:17.031 --> 00:01:20.006 There is no oxygen hooked up to this bag. 24 00:01:20.006 --> 00:01:22.048 If there were oxygen hooked up to this, 25 00:01:22.048 --> 00:01:27.011 we would be at high flow oxygen delivery with bag expanded. 26 00:01:27.011 --> 00:01:31.095 The way you do that is cover the outlet while it's on high flow, 27 00:01:31.095 --> 00:01:34.003 the bag would expand and fill with air, 28 00:01:34.003 --> 00:01:36.023 and you're ready to start ventilating to capture 29 00:01:36.023 --> 00:01:38.080 as much of that percentage of oxygen as possible. 30 00:01:38.080 --> 00:01:43.020 But we're just going to do room air, which is perfectly acceptable as well. 31 00:01:43.020 --> 00:01:45.053 In fact, some statistics and studies are showing that 32 00:01:45.053 --> 00:01:48.018 it might be just great to do it with room air. 33 00:01:48.018 --> 00:01:53.052 Remember, too, the bag valve mask is helping this person 34 00:01:53.052 --> 00:01:56.003 who might possibly be in cardiac arrest 35 00:01:56.003 --> 00:02:00.027 because we're not giving them any percentage of our carbon dioxide 36 00:02:00.027 --> 00:02:03.009 thereby contributing to their hypercarbia 37 00:02:03.009 --> 00:02:06.013 and the CO2 buildup in their body. 38 00:02:06.013 --> 00:02:08.030 So there is a benefit of that. 39 00:02:08.030 --> 00:02:12.007 The other benefit is we're not putting our face anywhere near the person's face. 40 00:02:12.007 --> 00:02:15.016 Therefore, protecting ourselves from infection as well. 41 00:02:15.016 --> 00:02:18.000 So, when we put this on the patient's face, 42 00:02:18.000 --> 00:02:22.053 we're going to make sure that the narrow, pear-shape of this mask 43 00:02:22.053 --> 00:02:25.045 is going on the bridge of the nose. 44 00:02:25.045 --> 00:02:29.072 Then, the wider or broader part of the mask 45 00:02:29.072 --> 00:02:33.051 is going to cover below the lips and above the chin. 46 00:02:33.051 --> 00:02:37.003 Then, coming in at the stem with our fingers, 47 00:02:37.003 --> 00:02:39.003 our C, our thumb and first finger, 48 00:02:39.003 --> 00:02:42.016 we're sealing in this case the left side of the mask 49 00:02:42.016 --> 00:02:46.001 while the E, or the middle, ring, and pinky fingers, 50 00:02:46.001 --> 00:02:49.036 grab the mandible, or the jaw of the patient, 51 00:02:49.036 --> 00:02:51.099 and again, this is after we have gone ahead and 52 00:02:51.099 --> 00:02:55.002 put the person's head in a good head-tilt, chin-lift position 53 00:02:55.002 --> 00:02:57.075 and we're drawing the face up into the mask. 54 00:02:57.075 --> 00:03:01.076 Now slowly, over a second, we're delivering a good rescue breath. 55 00:03:02.066 --> 00:03:04.053 Letting them exhale. 56 00:03:04.053 --> 00:03:07.053 Delivering another slow rescue breath. 57 00:03:07.053 --> 00:03:10.088 Looking for chest rise and fall. 58 00:03:10.088 --> 00:03:16.095 It's very easy to lose track of how fast you're ventilating 59 00:03:16.095 --> 00:03:20.002 the patient when you're using a bag valve mask. 60 00:03:20.002 --> 00:03:24.003 And there has been some statistics showing that we're actually 61 00:03:24.003 --> 00:03:26.058 hyperventilating patients that do not need to be hyperventilated. 62 00:03:26.058 --> 00:03:31.078 Remember, it's one breath over a second delivery is ideal. 63 00:03:31.078 --> 00:03:34.043 And for people that just need rescue breathing, 64 00:03:34.043 --> 00:03:36.013 we're trying to breathe for them about the average that 65 00:03:36.013 --> 00:03:38.095 a real, living, human being would need to be breathed for. 66 00:03:38.095 --> 00:03:42.007 One breath every 5 to 6 seconds and about 12 a minute. 67 00:03:42.007 --> 00:03:44.009 So we're not hyperventilating the patient 68 00:03:44.009 --> 00:03:46.088 unless the protocol is calling for hyperventilation 69 00:03:46.088 --> 00:03:48.026 then follow that protocol. 70 00:03:48.026 --> 00:03:52.016 So, I hope this was helpful for the bag valve mask. 71 00:03:52.016 --> 00:03:54.083 Practice makes perfect. Keep that in mind. 72 00:03:54.083 --> 00:03:57.011 And the more you can practice, the better.