A disposable BVM Resuscitator

A bag valve mask (also known as a BVM or Ambu bag) is a hand-held device used to provide ventilation to a patient who is not breathing or who is breathing inadequately. The device is a normal part of a resuscitation kit for trained professional, such as ambulance crew. The BVM is frequently used in hospitals, and is an essential part of a crash cart. The device is used extensively in the operating room to ventilate an anaesthetised patient in the minutes before a mechanical ventilator is attached. The device is self-filling with air, although additional oxygen (O₂) can be added. Download high resolution version (2560x1920, 786 KB) Wikipedia does not have an article with this exact name. ... Download high resolution version (2560x1920, 786 KB) Wikipedia does not have an article with this exact name. ... Ventilation good and very bad Ventilation is air circulation of air, typically between a room, a tunnel, etc. ... For other meanings of CPR, see CPR (disambiguation). ... An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ... For the town in the Republic of Ireland, see Hospital, County Limerick. ... A crash cart is a set of trays on a wheeled cart used in hospitals and emergency rooms which contains all the basic equipment necessary to follow ACLS protocols and save someones life, i. ... Look up air in Wiktionary, the free dictionary. ... General Name, symbol, number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, period, block 16, 2, p Appearance colorless (gas) pale blue (liquid) Standard atomic weight 15. ...

Use of the BVM to ventilate a patient is frequently called "bagging" the patient.^[1] Bagging is regularly necessary in medical emergencies when the patient's breathing is insufficient (respiratory failure) or has ceased completely (respiratory arrest). The BVM resuscitator is used in order to manually provide mechanical ventilation in preference to mouth-to-mouth resuscitation (either direct or through an adjunct such as a pocket mask. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... Respiratory failure is a medical term for inadequate gas exchange by the respiratory system. ... Respiratory arrest is the cessation of the normal tidal flow of the lungs due to paralysis of the diaphragm, collapse of the lung or any number of respiratory failures. ... mechanical or forced ventilation is the use of powered equipment, e. ...

Components

The Ambu Resuscitator bag or BVM, this version shows is a hybrid MkIII body, Mark IV head and with an old obsolete latex inflatable seal on the mask. The part labelled 1 is a flexible mask designed to seal to the patient's face, and the part labelled 3 is a self-filling bag, i.e. re-fills as an action of the elastic re-coil of the bag after compression.

The BVM consists of a flexible air chamber, about the size of a Rugby ball, attached to a face mask via a shutter valve. When the air chamber or "bag" is squeezed, the device forces air into the patient's lungs; when the bag is released, it self-inflates, drawing in ambient air or a low pressure oxygen flow supplied from a regulated cylinder. Image File history File links Metadata Size of this preview: 800 × 545 pixelsFull resolution (1576 × 1074 pixels, file size: 187 KB, MIME type: image/jpeg) File historyClick on a date/time to view the file as it appeared at that time. ... Image File history File links Metadata Size of this preview: 800 × 545 pixelsFull resolution (1576 × 1074 pixels, file size: 187 KB, MIME type: image/jpeg) File historyClick on a date/time to view the file as it appeared at that time. ...

A bag valve mask can be used without being attached to an oxygen tank to provide air to the patient, but supplemental oxygen is recommended since it increases the amount of oxygen reaching the patient.

Most devices also have a reservoir which can fill with oxygen while the patient is exhaling (a process which happens passively), in order to increase the amount of oxygen that can be delivered to the patient to about 80%

A BVM should have a valve which prevents the patient from re-breathing exhaled exhaled air and inhibit carbon dioxide accumulation Exhalation (or expiration) is the movement of air out of the bronchial tubes, through the airways, to the external environment during breathing. ...

Bag valve masks come in different sizes to fit infants, children, and adults. Most types of the device are now disposable, while others are designed to be cleaned. Fears about cross infection have rendered most re-usables non-viable.

Method of operation

The Laerdal Silicone resuscitator bag

The BVM directs the gas inside it via a one-way valve when compressed by a rescuer; the gas is then delivered through a mask and into the patient's trachea, bronchus and into the lungs. In order to be effective, a bag valve mask must deliver between 500 and 800 milliliters of air to the patient's lungs, but if oxygen is provided through the tubing and if the patient's chest rises with each inhalation (indicating that adequate amounts of air are reaching the lungs), 400 to 600 ml may still be adequate.^[1] Squeezing the bag once every 5 seconds for an adult or once every 3 seconds for an infant or child provides an adequate respiratory rate (12 respirations per minute in an adult and 20 per minute in a child or infant).^[2] Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... // These water valves are operated by handles. ... Look up trachea in Wiktionary, the free dictionary. ... Human respiratory system The lungs flank the heart and great vessels in the chest cavity. ... The millilitre (ml or mL, also spelt milliliter) is a metric unit of volume that is equal to one thousandth of a litre. ... It has been suggested that this article or section be merged with Minute volume. ...

Professional rescuers are taught to ensure that the mask portion of the BVM is properly sealed around the patient's face (that is, to ensure proper "mask seal"); otherwise, air escapes from the mask and is not pushed into the lungs. In order to maintain this protocol, some protocols use a method of ventilation involving two rescuers: one rescuer to hold the mask to the patient's face with both hands and ensure a mask seal, while the other squeezes the bag.^[3] However, as most ambulances have only two members of crew, the other crew member is likely to be doing compressions in the case of CPR, or may be performing other skills such as cannulation. In this case, or if no other options are available, the BVM can also be operated by a single rescuer who holds the mask to the patient's face with one hand, in the anaesthetists grip, and squeezes the bag with the other. An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ... A cannula (plural cannulae) is a flexible tube which when inserted into the body is used either to withdraw fluid or insert medication. ... An anesthesiologist (American English), or anaesthetist (British English), is a medical doctor trained to administer Australia, for example, training is overseen by the United States, anesthesiologists are medical doctors (MD). ...

When using a BVM, as with other methods of insufflation, there is a risk of over-inflating the lungs. This can lead to pressure damage to the lungs themselves, and can also cause air to enter the stomach, causing gastric distention which can make it more difficult to inflate the lungs and which can cause the patient to vomit. This can be avoided by care on behalf of the rescuer. Alternatively, some models of BVM (usually Paediatric) are fitted with a valve which prevents over inflation, by venting the pressure when a pre-set pressure is reached. Gastric distention is bloating of the stomach when air is pumped into it. ... Emesis redirects here. ...

An endotracheal tube (ETT) can be inserted by a trained practitioner and can substitute for the mask portion of the BVM. This provides a more secure fit and is easier to manage during emergency transport, since the ET tube is sealed with an inflatable cuff in the trachea, so that any regurgitation cannot enter the lungs. Such material can severely damage the lung tissue, and in the absence of an ET tube, could choke the patient by obstructing the airway. Inhalation of stomach contents can be fatal; the after effects can cause Mendelson's syndrome or aspiration pneumonia. Diagram of an endotracheal tube (10) that has been inserted into the airway of a patient. ... Regurgitation is the controlled flow of stomach contents back into the oesophagus and mouth. ... Human respiratory system The lungs flank the heart and great vessels in the chest cavity. ... For choking meaning compression of the neck, see Strangling. ... There are very few or no other articles that link to this one. ... Aspiration pneumonia is a specific form of lung infection (pneumonia) that develops when oral or gastric contents (including food, saliva, or nasal secretions) enter the bronchial tree. ...

Some rescuers may also choose to use a different form of resuscitation adjunt, such as an oropharyngeal airway or Laryngeal mask airway, which would be inserted and then used with the BVM. An oropharyngeal airway inserted into a mans throat An oropharyngeal airway or (OPA) is a medical device used to maintain a patent (open) airway. ... // The LMA was invented in the 1980s by the British anaesthetist, Dr. Archie Brain. ...

In a hospital, long-term mechanical ventilation is provided by using more complex devices such as an intensive care ventilator, rather than by a BVM, which requires at least one person to operate it constantly. Ambulance ventilation equipment A medical ventilator is a device designed to provide mechanical ventilation to a patient. ...

A flow-restricted, oxygen-powered ventilation device (FROPVD) is similar to a BVM in that oxygen is pushed through a mask into the patient's lungs, but unlike a BVM, in the FROPVD the pressure needed to push air into the patient's lungs is generated by oxygen via a pressure regulator from a cylinder rather than by squeezing a bag.

Ambu bag

One proprietary brand of a self-inflating BVM resuscitator, is called the Ambu bag. The concept for the original Ambu bag was developed in 1953 by the German engineer, Dr. Holger Hesse, and his partner, Danish anaesthetist, Henning Ruben. In 1956, the world's first non-electric, self-inflating resuscitator was ready for production by their company, Ambu A/S, which still produces a wide range of single-patient and multi-use resuscitators. Yet another new and exciting development in Bag-Valve mask resuscitaiton has recently been introduced on the market for emergency medical professionals. Click here to see the new design: [[1]]The mask portion is either strapped around the patient's head or attached to an Endotracheal (ET) tube/Combitube, while the oxygen tubing and actual "bag" are located a few feet away from the mask. This allows prehospital and hospital providers to deliver 100% oxygen at the same tidal volume as a traditional BVM, while giving the flexibility to control the bag from beside the patient instead of behind the patient's head. This new and innovative design not only makes delivery of supplemental oxygen easier, but allows the EMT or Paramedic to sit on the side of the patient and observe chest rise and fall as well as distention of the stomach. In major trauma situations, this also allows prehospital providers the opportunity to address other problems which may arise with the patient, such as bleeding, shock, or a tension pneumothorax, without the need for additional personnel or the temporary abandonment of BVM resuscitation. The mask is pre-fitted with a silicone facepiece to ensure a proper seal over the patient's mouth and nose. This design also reduces the risk of electric shock to emergency personnel when conducting defibrillation and eliminates the problem of attempting to hold the mask portion securely on the patient's face with one hand while attempting to "bag" the patient with the other hand or between the EMS provider's free hand and his or her leg. EMS providers with smaller hands as well as EMT-Paramedics will find this new BVM design very useful as it becomes more widely accepted. Click to the right to see this innovative mask design: [[2]]

See also

• Mechanical Ventilation
• Artificial respiration

mechanical or forced ventilation is the use of powered equipment, e. ... Wikibooks has a book on the topic of First Aid Artificial respiration is a technique for providing air for a person who is not breathing on their own, but whose heart is still beating. ...

References

1. ^ ^{a b} Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 140.
2. ^ Emergency Care, Pages 142-3
3. ^ Emergency Care, Page 141.

External links

• A free transparent reality simulation of the self-inflating manual resuscitator (Ambu bag)