Bag Mask Ventilation With Jaw Thrust

Of these jaw thrust is the most effective to open the obstructed airway in an anaesthetised child 16.

Bag mask ventilation with jaw thrust. The tongue often falls to the back of the pharynx which can occlude the airway. The jaw thrust technique should be practiced in the clinical environment. It is achieved by hooking the little fingers underneath the angle of the jaw. The jaw thrust lifts the mandible forwards and lifts the tongue off the posterior pharynx.

The manoeuvre is used for patients who require bag mask ventilation see image. Bag valve mask bvm ventilation is the standard method for rapidly providing rescue ventilation to patients with apnea or severe ventilatory failure. Hart d reardon r ward c miner j. Bag mask ventilation bmv is a foundational skill in airway management and a consideration in every airway intervention.

While tracheal intubation ensures optimal control of the airway for effective ventilation multiple attempts at intubation by the inexperienced operator may seriously compromise the child s ability to recover. A two handed jaw thrust technique is superior to the one handed ec clamp technique for mask ventilation in the apneic unconscious person. A jaw thrust is more suitable for patients who require bag mask ventilation since it is difficult to apply a mask and a chin lift simultaneously. It is not easy and requires practice to master as it will be utilized in emergent settings.

Evaluation for potential difficulty in bagging is a fundamental component of every airway assessment. Bvm ventilation is recognized as a two rescuer skill. Airway manoeuvres include jaw thrust head tilt and chin lift. Provision of artificial ventilation to the unconscious and apneic patient via a mask applied to the patient s face is the most basic of airway management skills nonetheless bag valve mask ventilation is not always easy.

Effective bmv reduces both the urgency to intubate and the anxiety that accompanies challenging laryngoscopy and intubation buying time as one works through potential solutions for a difficult or failed airway. The child s airway generally can be managed effectively before tracheal intubation with bag valve mask bvm ventilation with proper head positioning and jaw thrust. Since movement of the head and neck is contraindicated in the context of suspected significant cervical spine injury use a jaw thrust not the chin lift manoeuvre or indeed a pillow. Proper patient positioning is critical to the procedure.

See also airway establishment and control how to do head tilt chin lift and jaw thrust maneuvers how to insert an oropharyngeal airway and how to insert a nasopharyngeal airway in bvm ventilation a self inflating bag resuscitator bag is attached to a nonrebreathing valve and then to a face mask that conforms to the soft tissues of. Only rescuers with exceptionally large hands can effectively maintain an open airway displace the jaw into the mask and maintain a proper mask. Ventilation can then proceed with an assistant squeezing the bag or the use of a pressure controlled ventilator 15. Upper airway obstruction may be encountered at the level of the nares soft palate lips when the mouth is closed base of the tongue tonsillar pillars epiglottis.

Bag valve mask ventilation is a skill of utmost important for emergency providers. Journal of emergency medicine.