 Using the Bag & Mask
Using the Bag and mask in an emergency situation
can be a lot different to it's use on a training mannequin or dummy. The
main differences are: Contamination:
Contamination of the equipment by patient aspiration making ventilation difficult. Blood etc. can make
the equipment difficult to use. The Internal parts may become partially
or completely blocked. Non-Patient contamination can take place. Animal
faeces, urine, mould, chemicals etc. You name it! To
avoid this as much as you can by placing your equipment on a plastic bag
laid out on the floor beside you. Most Services use different colour
coded bags of various sizes and any of these are ideal. Seal:
Getting a seal on some patients can be much more difficult. For a start
no mannequin's seem to have beards. Or strange shapes or have injuries
to the face or head. Getting a seal on a guy with severe facial trauma
is almost impossible. Intubation is required in this type of patient. Using
the Bag & mask with an ET tube
Once your patient is intubated and you have verified good and equal air
entry you are then giving your hands and your partner a little more
freedom to get on with other tasks. Try squeezing the bag with your foot
or your knee whilst drawing up drugs etc. You'll be surprised how easily
you get used to it. Tip!
With those intubated patients in cardiac arrest you need to take your
hands away from the bag to do compressions. The bag starts rolling
around or falling off the side of the trolley! Try placing the bag onto
the patients upper chest/neck and tape the distal end of the bag onto
the patient's shoulder. This keeps the bag in place while you need to do
100 other things. Tip!
Wonder why they say don't ventilate with a bag & mask while doing
chest compressions? The most recent guidelines recommend alternating
your chest compressions with ventilation, suggesting that simultaneous
PPV and chest compressions may affect the efficiency of ventilation,
particularly when using a bag and mask, by forcing air into the stomach. | 
