BVM basics

VentMonkey

Family Guy
5,729
5,043
113

https://itunes.apple.com/us/podcast/the-flightbridgeed-podcast/id595147712?mt=2&i=1000385471827

Is anyone implementing either of these, or any of the forms heard in Eric's podcast?

I find mastery of the basics, and/ or reviewing the most effective ways of managing an airway even at the "basic level" further prevents a failed airway because it ensures the ability to oxygenate, and ventilate.

While the two-handed technique is far from new, it seems to constantly prove its worth over the infamous one-provider popular "E-C technique".
 
Last edited:

StCEMT

Forum Deputy Chief
3,052
1,709
113
Anytime I have enough hands (aka firefighters) on scene, absolutely. Better seal and it is easier to manipulate the head into a good position when both hands have a solid grip. Anytime I am not using two hands, it's because there is an SGA or ETT already in place.

What'd be nice is little head straps to hold them in place similar to the igel straps in the event you are stuck as the one provider, then that free hand could focus on position and not seal. There's your million dollar idea BVM makers, you're welcome.
 
OP
OP
VentMonkey

VentMonkey

Family Guy
5,729
5,043
113
Right, but short of clicking on the podcast link (not sure if it works. Sorry if it doesn't, and if not go to FlightBridgeEd and look for the latest podcast), have you considered the way you, or any providers "bag" the patient?

The podcast makes reference to utilizing pediatric BVM's in lieu of regular adult BVM's with patients who would otherwise benefit from lower Vt's, and/ or based on their size (height)--i.e., IBW--being delivered via pediatric BVM's, or different techniques if a provider does not possess a ventilator.

The harm done by our inaccurate, inconsistent, and oftentimes ineffective ventilatory methods are a key driver in the push for prehospital vents regardless of the level of paramedic provider.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,510
3,234
113
What'd be nice is little head straps to hold them in place similar to the igel straps in the event you are stuck as the one provider, then that free hand could focus on position and not seal. There's your million dollar idea BVM makers, you're welcome.

You mean like the ones that have been ubiquitous in OR's for probably going on 100 years now?

These non-disposable silicone ones are very common (and pretty cheap, I would imagine), but there are also disposable ones available.

2219452_l.jpg
 

Flying

Mostly Ignorant
571
370
63
I tried the chicken wing technique, impractically hard to do in an ambulance + looks silly but works in home settings.
Two person is by far the way to go. You get a better seal and there is a provider readily able to give feedback on the ventilation rate, something that's blocked by the cognitive bias of a single provider.
 

StCEMT

Forum Deputy Chief
3,052
1,709
113
You mean like the ones that have been ubiquitous in OR's for probably going on 100 years now?

These non-disposable silicone ones are very common (and pretty cheap, I would imagine), but there are also disposable ones available.

2219452_l.jpg
Exactly, but my handy dandy plastic bag lacks said piece of equipment. I really would like to keep a few reusable ones on the truck. I could see a lot of little ways this would help.
 

VFlutter

Flight Nurse
3,728
1,264
113
Two-thumbs up, or TE, is standard education for Airmethods. We are "required" to do so and document as such for our intubations. Works great.

Biggest pet peeve is showing up on scene with 2-3 people standing around and a person solo bagging. Two people technique every time. Also don't forget airway adjuncts.
 

NomadicMedic

I know a guy who knows a guy.
12,098
6,845
113
Anytime I have enough hands (aka firefighters) on scene, absolutely. Better seal and it is easier to manipulate the head into a good position when both hands have a solid grip. Anytime I am not using two hands, it's because there is an SGA or ETT already in place.

What'd be nice is little head straps to hold them in place similar to the igel straps in the event you are stuck as the one provider, then that free hand could focus on position and not seal. There's your million dollar idea BVM makers, you're welcome.


CPAP mask and adjuncts. You're welcome.
 

E tank

Caution: Paralyzing Agent
1,574
1,427
113
Goes without saying maybe?...do folks routinely teach/use an OPA when mask ventilating? I frequently am asked by students to assist in a two handed technique after some struggle that would be resolved immediately with a properly sized oral airway.

Even reasonable ventilation without one can usually be improved with one. If that's a given in this conversation, carry on...
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,510
3,234
113
Exactly, but my handy dandy plastic bag lacks said piece of equipment. I really would like to keep a few reusable ones on the truck. I could see a lot of little ways this would help.
I'm just saying that they are readily available and cheap, and work well.

I don't know why EMS and EM insist on constantly reinventing the wheel.
 

StCEMT

Forum Deputy Chief
3,052
1,709
113
CPAP mask and adjuncts. You're welcome.
Expensive head strap there, but point taken. I'll keep that idea tucked away. Just hate the idea of having to dig out an extra bag and waste half the stuff in it when there are cheaper options.

@E tank, yes. Unless its an OD, then I learn more towards NPA.

@Remi, don't doubt they're available on the market, I just don't have them and I have messed with BVM's that I couldn't use them with if I had them.
 
OP
OP
VentMonkey

VentMonkey

Family Guy
5,729
5,043
113
Piggybacking off of St, @Remi and @E tank glad you guys chimed in.

Aside from what's been offered up in your posts, do either of you guys have any common pearls, or pitfalls you'd like to share for us out-of-hospital folk?
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,510
3,234
113
Piggybacking off of St, @Remi and @E tank glad you guys chimed in.

Aside from what's been offered up in your posts, do either of you guys have any common pearls, or pitfalls you'd like to share for us out-of-hospital folk?

I don't really. Just be quick to place an OPA or NPA, and practice the basics every chance you get.
 

Brandon O

Puzzled by facies
1,718
337
83

Brandon O

Puzzled by facies
1,718
337
83
Hey thanks. I've actually perused your blog, and saved it to me work folder. It's been quite helpful.

Sure thing. But the last portion of the tutorial is the most important -- deciding what individual approach to bag-mask ventilation makes sense for you in your own setting. Collecting all the theoretical pearls in the world won't be much help otherwise. We all probably "know" a lot of things that aren't useful in our jobs.
 
Top