Transcript Chapter 14

Chapter 14
Artificial Ventilation
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Objectives
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Positive-Pressure Ventilation
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Positive-Pressure Ventilation
• Assisting breathing by forcing air into the
patient’s lungs
• Methods:
– Mouth-to-mask ventilation
– Mouth-to-barrier ventilation
– Bag-mask ventilation (BMV)
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Positive-Pressure Ventilation
• Differences between normal ventilation and
positive-pressure ventilation
– Air movement
– Blood movement
– Esophageal opening pressure
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Cricoid Pressure
(The Sellick Maneuver)
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Cricoid Pressure
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Cricoid Pressure
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Mouth-to-Mask Ventilation
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Mouth-to-Mask Ventilation
• Effective means of ventilation because:
– Two hands hold the mask in place
• Allows better face-to-mask seal
• Reduces the likelihood that air will leak from
the mask
– You can adjust volume of air to meet the
patient’s needs
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Mouth-to-Mask Ventilation
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Mouth-to-Mask Ventilation
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Mouth-to-Barrier-Device Ventilation
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Bag-Mask Ventilation
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Bag-Mask Ventilation
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Bag-Mask Ventilation
One Rescuer
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Bag-Mask Ventilation
Two Rescuers
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Adequate and Inadequate
Artificial Ventilation
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Adequate Artificial Ventilation
• Artificial ventilation is adequate when:
– The chest rises and falls with each
artificial ventilation
– The rate of ventilations is sufficient
– The patient’s heart rate improves
– The patient’s color improves
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Inadequate Artificial Ventilation
• Artificial ventilation is inadequate when:
– The chest does not rise and fall with each
ventilation
– The ventilation rate is too slow or too fast
– The heart rate does not improve with
ventilation
– The patient’s color does not improve
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Troubleshooting Bag-Mask Ventilation
• If chest does not rise and fall, reassess
– If chest does not rise, reposition head
– If air is escaping from under the mask, reposition
fingers and mask
– Check for obstruction
• If chest still does not rise and fall:
– Use alternative method of artificial ventilation
– If necessary, consider use of airway adjuncts
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Flow-Restricted, Oxygen-Powered
Ventilation Device
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Flow-Restricted, Oxygen-Powered
Ventilation Device
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Flow-Restricted, Oxygen-Powered
Ventilation Device
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Flow-Restricted, Oxygen-Powered
Ventilation Device
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Flow-Restricted, Oxygen-Powered
Ventilation Device
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Special Considerations
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Tracheal Stomas
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Bag-Mask-to-Stoma Breathing
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Bag-Mask-to-Stoma Breathing
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Dental Appliances
• Dentures that fit well should be left in place
• If they become loose or dislodged, remove
them
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Infants and Children
• Keep an infant’s nasal passages clear
• Keep an infant’s head in a neutral position
• Gastric distention is common when
ventilating infants and children
– When providing positive-pressure
ventilation
• Avoid using excessive volume
• Use only enough volume to cause a gentle
chest rise
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Questions?
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