Pro First Aid

1
00:00:02,055 --> 00:00:07,021
Alright, so let's take a look at the bag valve mask a bit closer.

2
00:00:07,021 --> 00:00:11,055
Professional rescuers are encouraged to use the bag valve mask whenever possible

3
00:00:11,055 --> 00:00:14,066
but one important aspect of this is that it takes practice.

4
00:00:14,066 --> 00:00:17,016
It's not that it's rocket science at all,

5
00:00:17,016 --> 00:00:21,035
but it just takes practice to be able to get your fingers placed correctly

6
00:00:21,035 --> 00:00:25,017
and to get your own technique down with some of the hints I'm going to show you

7
00:00:25,017 --> 00:00:28,062
to be able to seal the mask to the face of the patient.

8
00:00:28,062 --> 00:00:31,029
Another mistake that's commonly made is we think

9
00:00:31,029 --> 00:00:34,057
we're going to crush the mask down onto the face of the patient.

10
00:00:34,057 --> 00:00:36,090
When in reality, we're sealing it,

11
00:00:36,090 --> 00:00:41,069
but bringing the face of the patient up into the mask.

12
00:00:41,069 --> 00:00:43,078
Not mask down on patient's face.

13
00:00:43,078 --> 00:00:46,052
Face up into mask.

14
00:00:46,052 --> 00:00:52,008
That combined with sealing with the C-E method

15
00:00:52,008 --> 00:00:54,071
allows us usually to get a pretty good seal.

16
00:00:54,071 --> 00:00:57,036
Some of the reasons you might not get a good seal

17
00:00:57,036 --> 00:01:02,070
is deformity to the face, traumatic injury to the face, or a lot of facial hair.

18
00:01:02,070 --> 00:01:05,026
If that happens, you're going to do the best you can,

19
00:01:05,026 --> 00:01:08,064
but it's probably going to be an intubation patient at that point

20
00:01:08,064 --> 00:01:10,031
to be able to control the airway.

21
00:01:10,031 --> 00:01:14,069
But for this case, we're talking about basic life support with a bag valve mask.

22
00:01:14,069 --> 00:01:17,031
Notice, I've taken the reservoir bag off.

23
00:01:17,031 --> 00:01:20,006
There is no oxygen hooked up to this bag.

24
00:01:20,006 --> 00:01:22,048
If there were oxygen hooked up to this,

25
00:01:22,048 --> 00:01:27,011
we would be at high flow oxygen delivery with bag expanded.

26
00:01:27,011 --> 00:01:31,095
The way you do that is cover the outlet while it's on high flow,

27
00:01:31,095 --> 00:01:34,003
the bag would expand and fill with air,

28
00:01:34,003 --> 00:01:36,023
and you're ready to start ventilating to capture

29
00:01:36,023 --> 00:01:38,080
as much of that percentage of oxygen as possible.

30
00:01:38,080 --> 00:01:43,020
But we're just going to do room air, which is perfectly acceptable as well.

31
00:01:43,020 --> 00:01:45,053
In fact, some statistics and studies are showing that

32
00:01:45,053 --> 00:01:48,018
it might be just great to do it with room air.

33
00:01:48,018 --> 00:01:53,052
Remember, too, the bag valve mask is helping this person

34
00:01:53,052 --> 00:01:56,003
who might possibly be in cardiac arrest

35
00:01:56,003 --> 00:02:00,027
because we're not giving them any percentage of our carbon dioxide

36
00:02:00,027 --> 00:02:03,009
thereby contributing to their hypercarbia

37
00:02:03,009 --> 00:02:06,013
and the CO2 buildup in their body.

38
00:02:06,013 --> 00:02:08,030
So there is a benefit of that.

39
00:02:08,030 --> 00:02:12,007
The other benefit is we're not putting our face anywhere near the person's face.

40
00:02:12,007 --> 00:02:15,016
Therefore, protecting ourselves from infection as well.

41
00:02:15,016 --> 00:02:18,000
So, when we put this on the patient's face,

42
00:02:18,000 --> 00:02:22,053
we're going to make sure that the narrow, pear-shape of this mask

43
00:02:22,053 --> 00:02:25,045
is going on the bridge of the nose.

44
00:02:25,045 --> 00:02:29,072
Then, the wider or broader part of the mask

45
00:02:29,072 --> 00:02:33,051
is going to cover below the lips and above the chin.

46
00:02:33,051 --> 00:02:37,003
Then, coming in at the stem with our fingers,

47
00:02:37,003 --> 00:02:39,003
our C, our thumb and first finger,

48
00:02:39,003 --> 00:02:42,016
we're sealing in this case the left side of the mask

49
00:02:42,016 --> 00:02:46,001
while the E, or the middle, ring, and pinky fingers,

50
00:02:46,001 --> 00:02:49,036
grab the mandible, or the jaw of the patient,

51
00:02:49,036 --> 00:02:51,099
and again, this is after we have gone ahead and

52
00:02:51,099 --> 00:02:55,002
put the person's head in a good head-tilt, chin-lift position

53
00:02:55,002 --> 00:02:57,075
and we're drawing the face up into the mask.

54
00:02:57,075 --> 00:03:01,076
Now slowly, over a second, we're delivering a good rescue breath.

55
00:03:02,066 --> 00:03:04,053
Letting them exhale.

56
00:03:04,053 --> 00:03:07,053
Delivering another slow rescue breath.

57
00:03:07,053 --> 00:03:10,088
Looking for chest rise and fall.

58
00:03:10,088 --> 00:03:16,095
It's very easy to lose track of how fast you're ventilating

59
00:03:16,095 --> 00:03:20,002
the patient when you're using a bag valve mask.

60
00:03:20,002 --> 00:03:24,003
And there has been some statistics showing that we're actually

61
00:03:24,003 --> 00:03:26,058
hyperventilating patients that do not need to be hyperventilated.

62
00:03:26,058 --> 00:03:31,078
Remember, it's one breath over a second delivery is ideal.

63
00:03:31,078 --> 00:03:34,043
And for people that just need rescue breathing,

64
00:03:34,043 --> 00:03:36,013
we're trying to breathe for them about the average that

65
00:03:36,013 --> 00:03:38,095
a real, living, human being would need to be breathed for.

66
00:03:38,095 --> 00:03:42,007
One breath every 5 to 6 seconds and about 12 a minute.

67
00:03:42,007 --> 00:03:44,009
So we're not hyperventilating the patient

68
00:03:44,009 --> 00:03:46,088
unless the protocol is calling for hyperventilation

69
00:03:46,088 --> 00:03:48,026
then follow that protocol.

70
00:03:48,026 --> 00:03:52,016
So, I hope this was helpful for the bag valve mask.

71
00:03:52,016 --> 00:03:54,083
Practice makes perfect. Keep that in mind.

72
00:03:54,083 --> 00:03:57,011
And the more you can practice, the better.