• To ventilate and oxygenate a patient.
• A ventilation face mask may be used with an oropharyngeal or
nasopharyngeal airway during spontaneous, assisted, or controlled
• Ventilation bags (manual resuscitator) come in
2 types: self-inflating bag and flow-inflating (“anesthesia”)
• Ventilation bags used for resuscitation should be self-inflating.
• Ventilation bags come in different sizes: infant, child, and adult.
• Face masks come in many sizes.
• A ventilation mask consists of a rubber or plastic body, a standard
connecting port, and a rim or face seal.
• Supplemental oxygen can be attached to ventilation bags to provide
oxygen to the patient.
• Bag-mask ventilation gives the clinician time
to prepare for more definitive airway management.
• Good technique involves preserving good mask-face seal, inflating
the chest with minimal required pressure, and maintaining the optimal
patency of the upper airway through manipulation of the mandible
and cervical spine.
• The clinician should only use the force and tidal volume necessary
to cause the chest to rise visibly.
• The mask should extend from the bridge of the nose to the cleft
of the chin, enveloping the nose and mouth but avoiding compression
of the eyes.
• The mask should provide an airtight seal.
• The goal of ventilation with a bag and mask should be to approximate
• A neutral “sniffing” position
without hyperextension of the neck is usually appropriate for infants
• Avoid extreme hyperextension in infants because it may produce
• In patients with head or neck injuries, the neck must be maintained
in a neutral position.
• The upper airway consists of the oropharynx,
the nasopharynx, and supraglottic structures.
• The cricoid cartilage is the first tracheal ring, located by palpating
the prominent horizontal band inferior to the thyroid cartilage
and cricothyroid membrane.
• Cricoid pressure occludes the proximal esophagus by displacing
the cricoid cartilage posteriorly. The esophagus is compressed between
the rigid cricoid ring and the cervical spine.
• Open the airway via chin lift/jaw thrust
• Seal the mask to the face.
• Deliver a tidal volume that makes the chest rise.
• Tilt the head back and place a towel beneath
• If head or neck injury is suspected, open the airway with the
jaw thrust technique without tilting the head.
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