BVM questions

[onecrazykid108]

I know if someone is not moving enough air you should bag them, but is there an exact number of resp they should have before bagging? I mean 22 RR is fast, but not worthy or PPV. so is it like 10 and below and 30 and faster?

When should I bag the guy?

 

[Shishkabob]

If their own ventilations are not sufficient, that's when you help.

If they're fine at 8 a minute, or 38a minute, there's probably no reason to help. Everyone is different.

 

[MrBrown]

Remember oxygenation and ventilation are not the same thing so by squeezing the bag lots you are not helping.

Life threatning asthma six breaths a minute and no more.

 

[Jay]

I spoke to one of our instructors about this very question not too long ago and his advice was that adequate breathing is based on whether you think that they are getting enough O2 on their own without additional help.

Basically as a numbers rule an adult should have 12-20 resps/min, a child 15-30 and an infant between 25-50.

They should not be using accessory muscles and certain things will almost automatically indicate something is wrong such as cyanotic lips. From more of an ALS perspective an SpO2 below 92 would justify a non-rebreather but as far as bagging them you would need to see how they are doing on the NRBM and make a decision from there.

The key to bagging a conscious patient is to "help" them with their own natural breathing, by keeping an eye on their chest and squeezing the bag as you see their chest out and ready to breath in. Of course you will want the BVM hooked into the O2 @ 15LPM whenever possible.

 

[JPINFV]

If anyone is seriously looking for a magic number, here's a trick.

Take a deep breath over a five second period, hold for 5 seconds, exhale over a 5 second period. See how long you keep the cycle going.

Congrats. You are now breathing at 4 breaths a minute.

 

[Melclin]

If anyone is seriously looking for a magic number, here's a trick.

Take a deep breath over a five second period, hold for 5 seconds, exhale over a 5 second period. See how long you keep the cycle going.

Congrats. You are now breathing at 4 breaths a minute.

How does that help? It doesn't say anything about tidal volume or metabolic demand, capacity to transport oxygen etc. Of course you'd know that better than me, so I'm not quite sure what you're suggesting there.

 

[JPINFV]

How does that help? It doesn't say anything about tidal volume or metabolic demand, capacity to transport oxygen etc. Of course you'd know that better than me, so I'm not quite sure what you're suggesting there.

I'm suggesting that there is no magic number and you can have proper ventilation at 4 breaths/minute.

 

[Jay]

I'm suggesting that there is no magic number and you can have proper ventilation at 4 breaths/minute.

Not by our protocol... if breathing is below 12 resps on an adult patient then we can assist because they are below the normal and customary number of resps for an adult. Of course this is discretionary because we treat patients, not numbers so we would be looking for signs pointing to respiratory distress such as accessory muscle use. The general amount of resps for adult (12-20), infant (25-50) or child (15-30) patients is half of the battle when determining if they require assistance.

 

[JPINFV]

Not by our protocol... if breathing is below 12 resps on an adult patient then we can assist because they are below the normal and customary number of resps for an adult. Of course this is discretionary because we treat patients, not numbers so we would be looking for signs pointing to respiratory distress such as accessory muscle use. The general amount of resps for adult (12-20), infant (25-50) or child (15-30) patients is half of the battle when determining if they require assistance.

Emphasis added
...

This is why if I'm ever being attended, for what ever reason, by EMS, I'm half tempted to screw with them by varying my respiratory rate while still maintaining proper ventilation. Just because something is out of normal limits doesn't mean that it isn't normal for that patient.

 

[TraprMike]

more then a case, less then a 12 pack..

 

[8jimi8]

I spoke to one of our instructors about this very question not too long ago and his advice was that adequate breathing is based on whether you think that they are getting enough O2 on their own without additional help.

Basically as a numbers rule an adult should have 12-20 resps/min, a child 15-30 and an infant between 25-50.

They should not be using accessory muscles and certain things will almost automatically indicate something is wrong such as cyanotic lips. From more of an ALS perspective an SpO2 below 92 would justify a non-rebreather but as far as bagging them you would need to see how they are doing on the NRBM and make a decision from there.

The key to bagging a conscious patient is to "help" them with their own natural breathing, by keeping an eye on their chest and squeezing the bag as you see their chest out and ready to breath in. Of course you will want the BVM hooked into the O2 @ 15LPM whenever possible.

I guess I'm always the jerk who calls people out, but I think you need to do a little more reading, studying and have some ALS experience before you come in to explain anything. Your answers are dangerously incomplete and misleading.

 

[Melclin]

I'm suggesting that there is no magic number and you can have proper ventilation at 4 breaths/minute.

Gotcha. I completely misunderstood.