- All relevant infection control methods to be utilised.
- Position the patient as necessary
- Prepare equipment required:
- Bacterial filter MUST be attached always
- End-tidal CO2 (etCO2) must be attached regardless of adjunct for any use of BVM
- Ensure the BVM is functional; seal the mask connecter with your hand and depress the bag to ensure there are no leaks.
Note: In cardiac arrest, compressions MUST NOT be interrupted for more than 2-3 secs to facilitate ventilation. Work as a team.
- Adjust oxygen flow rate to 10-15 litres per minute and allow the reservoir bag to fill completely before and between ventilations.
- Place patient in the most optimal position.
- Place the apex of the mask over the bridge of the patient’s nose, and then seal the mask over the patient’s chin. Open airway with jaw thrust and chin lift.
- Utilise the 'anaesthetist grip' to ensure a firm seal of the mask on the patient’s face.
- Reposition as required.
- Ventilate the patient as necessary; avoid hyperventilation and/or hyperinflation.
- In asynchronous CPR, the inflation MUST occur on the decompression phase (~after every 10th compression)
- Place patient in supine position.
- Continuously ensure the patient’s airway is patent, use suction if required, apply basic airway management and progress to advanced airway techniques if required.
- Attach BVM oxygen tubing to inlet port on O2 cylinder and turn regulator knob to ensure the reservoir bag inflates fully.
- Create an effective seal between the BVM and the face.
- Use an inverted hand at the end of the bag to avoid excess volume and pressure
- SMART BVM - The flow limiter is on the neck of the BVM, it should be engaged to limit pressure and volume in cardiac arrest
- Gently compress the bag to ventilate the patient. These can be timed with spontaneous breaths if necessary.
- Gauge the effort required to ventilate through the feel of the recoil bag to achieve minimal rise and fall of the chest. Excess pressure and volume is detrimental to the patient.
- The following ventilation rates are a guide for normal respiration values. DO NOT EXCEED.
- Do NOT provide asynchronous ventilation in paediatrics
||40 - 60 breaths per minute|
|< 1 year
||30 - 40 breaths per minute|
|1 - 2 years
||25 - 35 breaths per minute|
|2 - 5 years
||25 - 30 breaths per minute|
|6 - 12 years
||20 - 25 breaths per minute|
|> 12 years
||15 - 20 breaths per minute|
||10 - 12 breaths per minute|
- If patient is not breathing at an effective rate, assisted ventilations are to be performed.
- BVM resuscitator kit volumes: