Adult Bag Valve Mask use on child?

[clibb]

Again, one can use adult AED pads on a child, and once I read in a medical journal about some doctor in a remote location using a car battery as a defibrillator.

I hope that helps!

Watch A-Team much?

 

[LucidResq]

You probably realize this, but just in case; the advantages of using a BVM without oxygen over a pocket mask are that you are delivering fresh air to the patient and not air you have exhaled already (less oxygen).
.

One of my lifeguard buddies carries a pocket mask with an inlet for 02. Actually think such a mask was required for whatever class she took for certification.

From a study that compared mouth-to-mouth, mouth-to-mask, BVM, and PFV (portable field ventilator), with paramedics as the operators:

Our results suggest that mouth-to-mask ventilation with supplemental oxygen enrichment is the most efficient technique for non-invasive airway management.

Johannigman, J. A., Branson, R. D., Davis, K., and Hurst, J. M. 1991. Techniques of emergency ventilation: a model to evaluate tidal volume, airway pressure, and gastric insufflation. The Journal of Trauma 31:93-98.


Another one that found mouth-to-mask ventilation produced more acceptable tidal volumes than BVM...

If clinical findings confirm these experimental results, mouth-to-mask ventilation should replace the bag-valve-mask system in the initial management of respiratory arrest.

Harrison, R. R., Maull, K. I., Keenan, R. L., and Paul Boyan, C. 1982. Mouth-to-mask ventilation: A superior method of rescue breathing. Annals of Emergency Medicine 11:74-76.


Not saying we should toss BVMs, but don't completely knock mouth-to-mask, especially with 02.

 

[Legacy_Camaro]

As a lifeguard, I would not be in favor of carrying a pedi mask and adult mask in my fanny pack along with all the other junk I have to carry
I carry a adult mask and if ever need to use it for a child, will just turn it around and use it that way till other guard arrives with proper size, or EMS arrives. I am not going to wait around for the proper size to start RBs.
If I did need to bag them, I would just watch for proper chest rise.
Do the newbie guards learn how to start a o2 tank? Or do you even have that?
Personally, I would have a hard time mentally using a BVM without o2 supply.

No, the lifeguards are not trained in o2. You are right though, i wouldn't carry around a ped mask in my fanny in addition to my adult one. Though, it's not like the fanny's we carry have anything in them anyway. So far we carry
1 CPR mask which is good, 3 Band-Aids Which confuses me why she has us carry those while on stand because we should be paying attention, and if someone needs a band aid they can go to the very close by first aid station to get a liquid bandage, because it's just going to fall off in the watery anyway. and some of them have 1 packet of burn cream, which makes no sense at all because its an indoor pool and i little packet of sunburn lotion isn't going to be needed at all while on stand.

I stock my own fanny however, haha.

for the most part, if a child/infant needed resuscitation, I would just use mouth to mask. I will more than likely not use the adult BVM, though i'm sure its possible in an extreme situation, not that its something i think should be attempted when mouth to mask is available.
She was saying to the other guards to give small puffs. I think better tidal volume could be achieve via mouth to mask than with puffs from an adult BVM, but I'm still unsure.

 

[LucidResq]

She was saying to the other guards to give small puffs. I think better tidal volume could be achieve via mouth to mask than with puffs from an adult BVM, but I'm still unsure.

See above studies. You may very well be right. Some studies have shown BVMs, especially when operated by a single rescuer, do NOT provide adequate tidal volume (ie meeting AHA standards).... and this is when the BVM fits.... adult BVM on adult patient. I imagine that with a poor seal due to a too-large mask... you're going to get even worse results.

My only question is.... are you going to get a good seal with a CPR mask designed for adults anymore than with a BVM?....

 

[8jimi8]

See above studies. You may very well be right. Some studies have shown BVMs, especially when operated by a single rescuer, do NOT provide adequate tidal volume (ie meeting AHA standards).... and this is when the BVM fits.... adult BVM on adult patient. I imagine that with a poor seal due to a too-large mask... you're going to get even worse results.

My only question is.... are you going to get a good seal with a CPR mask designed for adults anymore than with a BVM?....

at least you can use both hands to mold an adult mask down on a tiny face, no?

 

[redcrossemt]

No, the lifeguards are not trained in o2. You are right though, i wouldn't carry around a ped mask in my fanny in addition to my adult one.

Your guards are not trained in emergency oxygen administration? That's pretty unusual, around here at least.

If I were lifeguarding, I'd only carry the adult size pocket mask.

I'd also advocate for the jump kit or whatever backup resource we have to contain BVMs of all sizes. Stocking only the adult size is setting yourself up for a loss in court. Hopefully you can resuscitate your patient without any neurological defects, otherwise they'll be blaming you and looking for reasons.

Lawyer: So, sir, you do see infant and child patrons and visitors all day long? But you thought it was okay to only stock medical equipment to treat adults? Mhm, and why? Oh, to save $15? I rest my case.

Also of note, if you are going to deliver rescue breathing using a mask without an oxygen inlet, you as the rescuer can wear a nasal cannula to promote higher levels of oxygen in the delivered breaths.

 

[redcrossemt]

My only question is.... are you going to get a good seal with a CPR mask designed for adults anymore than with a BVM?....

Yes! The thing is two hands available to hold the seal. With a bag, one hand is on the bag and not on the mask where it needs to be. The next time you do CPR have an extra set of hands helping with mask seal and you'll notice a huge difference even in just an adult.

That being said, I think the right mask size would always be preferred.

 

[8jimi8]

Your guards are not trained in emergency oxygen administration? That's pretty unusual, around here at least.

If I were lifeguarding, I'd only carry the adult size pocket mask.

I'd also advocate for the jump kit or whatever backup resource we have to contain BVMs of all sizes. Stocking only the adult size is setting yourself up for a loss in court. Hopefully you can resuscitate your patient without any neurological defects, otherwise they'll be blaming you and looking for reasons.

Lawyer: So, sir, you do see infant and child patrons and visitors all day long? But you thought it was okay to only stock medical equipment to treat adults? Mhm, and why? Oh, to save $15? I rest my case.

Also of note, if you are going to deliver rescue breathing using a mask without an oxygen inlet, you as the rescuer can wear a nasal cannula to promote higher levels of oxygen in the delivered breaths.

awesome, never thought of that

 

[LucidResq]

at least you can use both hands to mold an adult mask down on a tiny face, no?

Good point. Not saying you couldn't do it but I haven't played with these masks at all before so I don't know what they're like.

This pocket mask, which is what I was referring to my friend carrying, states "can be used on adult, child and infant," but they also sell a pediatric size....

 

[LucidResq]

Hell, why don't we all chip in a dollar or so and buy Legacy one of those pediatric masks - they're only $13. You said you have room in your fanny pack so no excuses! Then we can all feel really good about ourselves when he resuscitates some little tyke back to life. Or we can go for broke and buy them a BVM for $14!!

 

[lightsandsirens5]

Yes! The thing is two hands available to hold the seal. With a bag, one hand is on the bag and not on the mask where it needs to be. The next time you do CPR have an extra set of hands helping with mask seal and you'll notice a huge difference even in just an adult.

That being said, I think the right mask size would always be preferred.

If the big deal here is that sealing an adult BVM mask to a kiddo with one hand is impossible, but with two hands is, then I would say it could be solved by the application of another person. At the pool in my area, there are always at least 5 lifeguards, two on the pool and one one the wading pool and two on break not to mention office staff. Chances are that by the time the gaurd gets the kid out of the water, there will be way more than enough people to help. Even if the gaurd is an idiot and doesn't alert the rest of the staff before going in, in a matter of what, 15 seconds, everyone else can be there.

So maybe for a two person ambulance crew with no fire or first response coverage it is a big deal. You don't want the caregiver doing ped resc with an adult mask by himself. But in a setting like a pool with pleanty of trained people around.......?

That being said, if the only reason your staff will not supply them is because they cost $15, that is a whole different issue.