sack jears

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As an emt fresh from the national registry without any job experience I've never bagged a patient. I imagine it's much harder to get a good seal and chest rise than it is on our mannequins at school. Is it more difficult than what I've been taught? Tips and tricks? This may be a simple question but the only dumb questions are the ones I don't ask so let's hear it
 

Aprz

The New Beach Medic
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I don't think it is more difficult than what it is taught. To me, it doesn't really seem any different ventilating a mannequin or a real person. The only difference I've felt is that a BLS airway helps way more when you are ventilating a real person vs a mannequin. Make sure that you see rise and fall of the chest to confirm that you are giving breaths. Have suction nearby and ready if needed like you were trained with the airway scenario. The most common problem I've read is people hyperventilating the patients so avoid doing that.
 
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Tigger

Dodges Pucks
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Two person if at all possible. If the cheeks are inflating, you don't have an open airway, despite what some may say. No leaks does not necessarily mean your tidal volume is going where you want it. Look for chest rise. Pay attention to how your rate and how hard you squeeze (your volume).
 

StCEMT

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Just pay attention, it isn't really harder. If the chest is rising, then you know you are doing good.
 

Jim37F

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The only difference I've felt is that a BLS airway helps way more when you are ventilating real person.
I can attest to this. A little while back we were assisting ventilations on a patient with a GCS of 1-1-1 (total of 3). We got them on the gurney and I was bagging whilst wheeling out to the ambulance and I had some decent resistance. We were still able to see chest rise/fall, but all I had assisting me was positioning. Once inside the rig I dropped an OPA and voila, no resostance, nice easy ventilations. So of you're going to bag someone, when at all possible use an airway adjunct.

I will also say there's a difference between breathing for someone, and assisting someone who is breathing (just inadequately). IME THE more agonal the patient is, the easier to use the BVM. There's a "trick" I've found helpful, where you squeeze the bag just a little to get the resistance...then when the patient naturally breathes in the pressure you're putting on the bag naturally squeezes the oxygenated air in as the patient is breathing in so you're not fighting them. I personally think that that's easier than trying eyeball chest rise then squeeze the bag (especially when being bounced around in the back and you have a medic doing stuff as well...)
 

cprted

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Two person technique always, so long as bodies are available. Watch your rate, 8-12 per minute, if you're not actively counting you will end up bagging at 30/min before very long. 1/3 to 1/2 half of the bag, just enough to make the chest rise. When holding a seal, think of pulling the patient's face up into the mask as opposed to pressing the mask down on the face.
 

SeeNoMore

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I thought I was "good" at BVM ventilation , or at least of normal skill level. Then I spent a lot of time in the OR and continue to do so many times a year. That knocked me down a few pegs but also gave me some great education. In short : it's not an easy skill but its extremely important. Focus on staying calm and not being satisfied with sub par efforts. Use an OPA / NPA , two handed technique, careful volume delivery and don't hyperventilate. Your team should be working together - support each other by calling out and assisting with issues. "Hey you're bagging too fast" etc.
 
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