Mouthtomask ventilation

The pocket mask is an excellent device that allows effective ventilation of a patient by less experienced personnel (Baskett et al. 1996). The mask provides protection to the rescuer through a one-way valve system. The pocket resuscitation mask is an anatomically shaped facemask with a cushioned under-edge. Most are marked to guide positioning of the mask on the patient's face. Some masks have an oxygen inlet, which allows supplemental oxygen to be given in addition to the rescuer's breaths. If no oxygen inlet is present, supplemental oxygen may still be administered by placing the oxygen tubing directly under the mask. There must be a good seal between the mask and the patient's face.

Technique

Ideally the patient should be in a supine position.

• Remove the mask from its container and form it into the correct shape by pushing the dome part forward (see Figure 7.7).

• Attach the one-way valve to the mouthpiece.

• Wear the gloves that are provided in the pocket mask container.

• Standing beside the patient or behind the patient's head, apply the mask to the patient's face. Use the bridge of the nose as a guide for correct placement.

• Apply firm pressure onto the cushioned part of the mask using your fingers and/or thumbs in a position that is comfortable and ensures a good seal between the mask and the patient's face.

• Perform head tilt/chin lift to open the airway.

• Blow gently through the one-way valve and look for chest movement. The chest should rise as with normal breathing. It is not necessary for the rescuer to deliver large breaths to effectively ventilate the patient's lungs.

• Allow the patient to exhale between each ventilation. Watch for the chest to fall before giving the next breath.

• Be aware that it may be difficult to get an adequate seal on the first attempt. In this situation reposition fingers and thumbs, adjust the mask and be sure the airway is opened correctly.

• An oral airway may be used to assist in maintaining the airway when using the pocket mask. However, attempted ventilation should not be delayed if one is not immediately available.

• Once oxygen is available, it should be attached to the oxygen inlet at a flow rate of 10 litres per minute. It is still necessary for the rescuer to blow into the mask to provide ventilation (see Figure 7.8).

Fig. 7.7 Assembly of pocket mask.
Fig. 7.8 Mouth-to-mask ventilation with additional oxygen attached.
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