Equipment for managing breathing

Figure 3.2 is an example of how the 'breathing drawer' of a cardiac arrest trolley may be laid out. In some departments, the bag-valve-mask system may be found readily attached to the oxygen and in a more accessible location, where it can be seen hooked on the drip stand. However, if it is located in the drawer as indicated below, it is less likely to accumulate dust.

Bag-valve system

This system is often referred to as the 'Ambu-Bag'TM. It consists of a self-inflating bag and a one-way non-rebreathing valve. When the bag is squeezed the air is delivered to the patient's lungs via the one-way valve. On releasing the squeeze, the bag self-inflates with room air that enters via an inlet at the opposite end of the bag. When oxygen becomes available, a reservoir bag should be attached to this inlet and the oxygen flow set at 10-15l/min. The patient's exhaled air is released back into the atmosphere by the one-way valve and does not contaminate the contents of the bag. The bag-valve device may be used with a facemask, a laryngeal mask airway, an endotracheal tube or a Combitube (Resuscitation Council UK 2000).

Pocket mask

• The pocket mask is a facemask that allows mouth-to-mask ventilation of the patient (see Figure 3.2, item 4).

• It is available with or without an inlet that allows additional oxygen to be attached. Preferably one with an oxygen inlet should be used in the hospital setting.

• The pocket mask is available in one size for adults and will allow a good seal in most casualties.

• For guidelines on sizing and insertion, see Chapter 7.

Non-rebreathe oxygen masks

• For the patient who is spontaneously breathing, an oxygen mask should be available (see Figure 3.2, item 2).

• The non-rebreathe oxygen mask has a reservoir bag attached, allowing an oxygen concentration of about 85% when delivered at a flow rate of 10-15l/min.

More information on the use of ventilation equipment may be found in Chapter 7.

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