Pocket mask vs BVM

DesertMedic66

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This.

They don't teach pocket mask in AHA HCP BLS. Not that I remember and I've taken it a few times...

We still teach it and have to test students out on it.
 

Tigger

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I can't get anyone to two person BVM with me here. It's absurd. "We don't have enough hands!" Really? There's two firefighters standing there looking for something to do...solved.
 

RebelAngel

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We're very small. Typically it's one EMT and the ambulance driver on runs.

I do agree with being aware of options. Where I work it'd be pretty rare to not have enough hands around to have a two person BVM going.

When I've had to start bagging in the back with no FF on board (or on scene and fire isn't there yet) I take a BVM mask, my silly little demand valve "ventilator" and attach the circuit to the mask and set it then hold the mask with two hands while the vent cycles at the set RR/TV.

Also our CPAP masks are compatible with these circuits as well and I've had good luck with that with conscious patients that needed PPV and weren't nauseous or actively vomiting. Then I don't even have to hold anything.
 

Tigger

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We're very small. Typically it's one EMT and the ambulance driver on runs.

I'd hope the driver has a CPR card though. And even if they don't, it doesn't take a course to squeeze the bag when told.
 

Carlos Danger

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We're very small. Typically it's one EMT and the ambulance driver on runs.

All the more reason to try to become proficient with single-person mask ventilation.

It's not an easy skill to learn, and sometimes it's nearly impossible to do. But if you try to get good at it, there will be times that it comes in handy.
 

mycrofft

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I think the crux of statements praising the pocket mask are based upon it being very difficult for many people to do a BVM by themselves, so they can use a pocket mask individually. Rinn, I didn't mean to sound demeaning.

Inflations or rescue breathing in a code, especially at the very first, are important in the algorithm besides making sure the blood we're compressing around is still red not blue, because in an unwitnessed man down with loss of consciousness and apparent pulselessness/apnea, there is no other way to ascertain that there is not a supratracheal airway embarrassment.

"Codes" originating from airway embarrassment are much more "salvageable" than codes originating from lethal MI, or series of MIs. However, pumping away and ignoring that cocktail weeny wedged by the epiglottis just evened out the playing field to about 0%.
 

mycrofft

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PS: I demonstrate to my CPRO students how tricky it is to do a one-man BVM, then go on to show how to do it and use the video as a basis for what can be done better (e.g., GRAB that mask with your hand, not your fingers as shown, and get it right up by the connector to the valve, making a seal any way you can without losing the airway).
 

Brandon O

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"Codes" originating from airway embarrassment are much more "salvageable" than codes originating from lethal MI, or series of MIs. However, pumping away and ignoring that cocktail weeny wedged by the epiglottis just evened out the playing field to about 0%.

I think you may be overestimating the number of unwitnessed arrests that are due to cocktail weenies.
 

mycrofft

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Anyone eating cocktail weenies without witnesses might be a bachelor borderline alcoholic.

He might be an EMT.

But, I am repeating myself.;) *
-------------------------------------------
Many more codes IN ADULTS will be due to MI or stroke than airway embarrassment, but even the first attempt to ventilate will hopefully assess whether the airway is patent or not. I show my students a two-foot diameter pie chart with a skinny little slice out of it. The slice represents the non-MI/non-CVA true codes, which is airway embarrassments, electrocutions, etc (and largely kids), and the best candidates for a save.


*Apology to Mark Twain's joke about US senators and liars.
 

DrParasite

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This.

They don't teach pocket mask in AHA HCP BLS. Not that I remember and I've taken it a few times...
Throwing the BS flag on this.

Feel free to check out the AHA CPR guidelines here http://www.evms.edu/media/evms_publ...r_life_support/AHA_SKILL_CHECK_SHEETS_ALL.pdf under step 4, after minimizing interruptions.

I'm not saying I would be ever using one in the field, but it is taught in class, and you should be proficient in it if you have a valid AHA HCP card.

btw we don't get the FD on cardiac arrests. usually a 2 person BLS crew and a 2 person ALS crew.
 

mycrofft

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Opened the link...

I thought ARC paperwork was like income tax!

I see BVM for BLS but not rescue mask. Am I missing it?

I do not like make-believe scenarios. I think they are insulting to adults unless they are good at and like "make believe". I prefer to make them demonstrate skills while I furnish correction PRN.
Ben-Hur-007.jpg
 

Handsome Robb

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Throwing the BS flag on this.

Feel free to check out the AHA CPR guidelines here http://www.evms.edu/media/evms_publ...r_life_support/AHA_SKILL_CHECK_SHEETS_ALL.pdf under step 4, after minimizing interruptions.

I'm not saying I would be ever using one in the field, but it is taught in class, and you should be proficient in it if you have a valid AHA HCP card.

btw we don't get the FD on cardiac arrests. usually a 2 person BLS crew and a 2 person ALS crew.

Well I can provide a copy of my card. Like I said I very well could've toned it out and missed it. Very possible. Who knows.

I know how to use a pocket mask. Had to demonstrate it plenty of times in my lifeguarding career. Demonstrating it once on a mannequin doesn't equal proficiency.

:)
 

mycrofft

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... Work a few messy arrests, and you'll learn the very last thing you want to do is get your face right next to the chum fountain.

DEMedic…some things can't be unheard. Or unread. Man oh man oh man….:wacko:
 

ThadeusJ

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Pocket masks were designed to be used by the lay person and now that they recommend compressions only for one person CPR, they should still be carried in the event that two people are there and want to do something for the patient.

For the skilled medic, BVM's are far superior for their ability to 1) provide 100% oxygen, 2) provide and gauge the quality of ventilations, 3) allow the user to view the scenario better (you can't really see the scene when you're face to face with your patient). Although good pocket masks have filters, BVM's place you at arm's length and the good ones allow you to place a filter on the exhalation port (although I have found that most services don't even carry filters).

Pocket masks may be advocated due to their lower cost, but in my opinion they have no place in a professional service (maybe in your car for the way home, but not on an ambulance).
 

Household6

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This is Limmer, Emergency Care 12th Edition.. I remember that I highlighted it, because I didn't think it was right.. But it did come up on the test. I keep a pocket mask with an O2 port in my First Responder bag.. I haven't used it yet.

C3587160-E1AC-473D-9F90-664F7E53D425_zpsu7lainjj.jpg
 

mycrofft

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This is Limmer, Emergency Care 12th Edition.. I remember that I highlighted it, because I didn't think it was right.. But it did come up on the test. I keep a pocket mask with an O2 port in my First Responder bag.. I haven't used it yet.

Check that mask periodically. Those with O2 nipples can become too stiff to open up
 

ThadeusJ

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Regarding the quote from a textbook, I have to caution that we shouldn't take things from texts unless they are referenced. Anyone can write a text and use "experts" to fill in the blanks. As we know, the death knell for quality is doing something because "we've always done it this way and it seems to work".

I attend a lot of conferences and have come across several paramedic texts that are just plain wrong. In one, I saw an oxygen setup that was quite dangerous and went looking for it as an example here. Well, today on one of my Respiratory Therapy Facebook groups, this was found in a hospital (The exact same setup seen in the text I was referring to). I have to share this with the group as example of what you see in a text ain't necessarily correct:
photo.php
 

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chaz90

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In one, I saw an oxygen setup that was quite dangerous and went looking for it as an example here. Well, today on one of my Respiratory Therapy Facebook groups, this was found in a hospital (The exact same setup seen in the text I was referring to). I have to share this with the group as example of what you see in a text ain't necessarily correct:
photo.php

Okay, I'll admit to my ignorance. I know absolutely nothing about how this should be set up. What is it (large volume nebulizer/humidifier?), what's wrong with it as is, and how should it be set up?
 
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