# Pocket mask with strap as supplemental oxygen mask?



## mycrofft (Mar 1, 2011)

A vendor is marketing the use of their version of a pocket rescue breathing mask with oxygen nipple and one way valve *AND an elastic rubber band type head strap *for universal use in supplemental oxygen administration. 

My question is this: since, with the peripheral cuff and elastic band, the mask should theoretically achieve a seal except for the one way valve, isn't it really a resuscitation mask? Or does the one way valve (or its socket, if it is pulled off) offer enough airspace so that most patients can breathe without assistance? (Obviously, if they are struggling, they will need to be bagged, valved, or given rescue breathing).

Please advise if you *know* the answer, conjecture is not very useful here. The manufacturer insists it is ok, but will not actually state in writing that the valve will allow enough air flow.


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## Melclin (Mar 1, 2011)

Link to the device?


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## jjesusfreak01 (Mar 1, 2011)

I have one of these, its a Red Cross pocket mask that they give you when you take their CPR Provider course. It should get a decent seal, but its only going to give you a few percent more O2 (attached to supplemental oxygen), primarily because there isn't much space for O2 to sit inside the mask. I believe its connector is compatible with a standard BVM, however, so you could use it as a replacement for the BVM mask, though I don't see any good reason to do so.


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## WTEngel (Mar 1, 2011)

I am a red cross CPR FPR instructor, and this is the standard mask they hand out. If you strapped it to the person's face without supplemental oxygen, they would be breathing normal 21% oxygen, nothing about the seal or one way valve inhibits breathing. When you attach supplemental oxygen at 10 LPM it should be equivalent to a simple face mask. there isn't enough dead space to worry about exhaled CO2.

The previous poster is correct that there are versions out there that do not interface with standard BVMs. So if someone comes with a BVM, plan on using the entire setup, mask and all.


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## WTEngel (Mar 1, 2011)

Here is a link to a common brand. I'm not trying to sell these by any means, but I wanted to show example....

http://knoxarc.org/index.php?page=s...ion=com_virtuemart&Itemid=1&vmcchk=1&Itemid=1


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## mycrofft (Mar 2, 2011)

*Clarification*

This is like the standard "pocket mask" with an O2 nipple, same as the Am Red Cross one. Some brands come with an elastic head strap.






If the seal is tight and the one way valve or its port interfere's with inhalation (breathing through a 1 cm dia hole), then the pt is more dependent upon the incoming O2; that would mean it was more than merely "supplementary", and would need to run much higher than the customary 6 to 15 LPM for supplementary O2 masks.
As for CO2 buildup, if the one way valve is in place, and the mask is sealed, how do you exhale? If the valve is pulled off, then again you are exhaling through an orifice slightly smaller in diameter than my pinkie finger's distal phalanx.

Sidebar: Pocket masks that don't fit onto a BVM? Is that the oine way valve that doesn't mate up, or have they changed the orifice the valve fits into?


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## WTEngel (Mar 2, 2011)

The one way valve redirects the patient's exhaled air so it does not go into the rescuers mouth during patient exhalation. 

I think that might be the misunderstanding you have. When used for rescue breathing the one way valve is activated by the rescuer blowing air through the mouthpiece. Once the rescuer stops blowing the valve closes, preventing exhaled air coming through the rescuers end. The action of the valve closing opens the redirect port on the backside of the rescuer mouthpiece for redirection of the patient's exhaled air. It doesn't actually physically hold any air in the patient, unless the rescuer is physically blowing through it to activate the valve...

Not the most eloquent explanation, but without you in front of me to physically show you the device, I'm afraid that's the best you get! Clear as mud?


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## Melclin (Mar 2, 2011)

As WT says, the valve is no problem. Its not a simple one way valve. Its a redirect valve. Air can easily escape, just not into the rescuers mouth. 

I have one in front of me and I just tried it out. My bigger issue is the bacterial filter. There is too much resistance to be comfortable in a healthy person (me), let alone a sick person. 

Maybe it would change with many many litres of O2 running...


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## WTEngel (Mar 2, 2011)

I will step out there and go ahead and say it. By design, the devices should work for both assisted respirations and as a supplemental oxygen device.

In practice they are a device of last resort (as any breathing barrier is) and should only be used if a BVM is not present. Also, in practice they are probably the last choice I would pick to deliver supplemental o2. If I had nothing else available I would possibly use it for blow by. With that said, I've encouraged any place I have trained staff at who has oxygen in their workplace first aid kit that they should really have a selection of appropriate devices like NRBs, facemasks, etc.

Anyway, if you have an option, this would not be my first choice. However, if this is all you have, go for it, it probably won't hurt... And if it does, just remove it, or if the patient hates it enough, believe me, they will remove it themselves!


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## Sandog (Mar 2, 2011)

Maybe a stupid question, but if the PT. is not breathing so well, wouldn't the one way valve not be to effective as well?

-----------edit--------------------------------------------

I should have read WT last post before making my post... erm


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## EMTGunney (Mar 2, 2011)

*ummm no*

i will go out and say this. if a pt is in need of oxygen and you only have this mask then yes use it, but its not ideal, and if that is all you have either shift hit the fan... HARD or you did not check out your rig. what you should really be using is a NRB or a simple mask, NRB is preferable.


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## mycrofft (Mar 3, 2011)

*Thanks all.*

Well, it seems an expensive way to deliver supplemental oxygen versus a good old Hudson mask. The seller is adamant it is supposed to be used like any other mask for supplemental O2, Laerdal doesn't respond when asked.


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## jjesusfreak01 (Mar 3, 2011)

mycrofft said:


> Well, it seems an expensive way to deliver supplemental oxygen versus a good old Hudson mask. The seller is adamant it is supposed to be used like any other mask for supplemental O2, Laerdal doesn't respond when asked.



I see no reason it wouldn't work just fine for blow-by oxygen. Otherwise, its going to be inferior to just about every other delivery method.


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## MasterIntubator (Mar 3, 2011)

Wow.... those things have been around forever.  I dug thru my training box of stuff we used to use and have the manual for it ( laerdal item # 83 00 03 ).

It states that it can be used with or without oxygen, during CPR or spontaneous inhalations.  The recommend O2 flow rates ( per the chart in the instructions ) is ( CPR - 5-10 lpm ) ( spontaneous resps 15 lpm @ about 80% inhaled O2)

The one way valve has an exhale port on the underside, and has low inspiratory and expiratory resistance ( 2.4/2.9 cm H20 respectively ).. add another 2-3 cm H20 for the model with a filter.

We no longer use them.... they have been replaced by a BVM.


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