04 October 2011

Resuscitator Bag / Bag Valve Mask / Ambu Bag

okay okay did you get it back

no this is on camera okay okay so this is they'll either call it the Ambu bag or the resuscitator Bank okay so here's their bull camping bags or resuscitator bags you're going to identify the following so one the inflation bag which is this part here the oxygen reservoir is here here and the reason why you have a reservoir on any device is it increases the amount of oxygen so again you're not just getting what's coming from the flow meter but you're also it's able to pull from the reservoir so this fills up with oxygen as well as what's coming through the tubing oxygen attachment port so this is what's going to attach to the flow meter look at how it's designed it can either be screwed on without a Christmas tree or a nipple adapter or you can just push it right on to the the nipple adapter so that's the nice thing about these new ones is they'll work with or without a Christmas tree the breathing valve assembly is this whole piece right here and mask or endo tube so now this could hook to the this Ambu mask or if the patient is intubated it hooks right to the in Detroit with the mask or without it will hook on

right there okay and then the exhalation port on this one is here and so what you're going to do is one describe the type of patients and exhalation valve with each resuscitate obey well first of all what type of patient would you use this on do you think I think you'd use it on everybody that comes into the hospital so it has to be somebody that obviously is having some type of respiratory failure they can't breathe on their own so it would be somebody who with with respiratory failure that cannot breathe on their own so you're not going to just come up and give because what if somebody's having no breathing problems they're awake and alert or you're going to go here I'm just going to give you a couple breaths now you're not going to do that to somebody so this would be somebody that already has a comprar compromised respiratory problem that they can't read on their own also on the resuscitator bag they have different types of exhalation valves okay so this one if I unscrew it you'll be able to see it has a diaphragm so this one has a diaphragm exhalation valve you see the orange piece

then this one is called when you squeeze it it looks like a duck bill and that's what it's called a duck bill oh that's like a glottis yeah duck bill so see how you squeeze it and it opens out this one's a diaphragm squeeze it and it pushes the diaphragm forward but air can't go back into the Ambu bag that's what the exhalation valves about see when I squeeze a oxygen goes from here into the patient but it can't go back into because once I'm done squeezing is about close the diaphragm when I squeeze oxygen goes this way but you can't it can't come back into the Ambu bag why would that be important what difference would it make why would I not want the patient's exhaled air to go back in here you don't want to give them carbon dioxide right so if carbon dioxide goes in here it's going to decrease my fio2 so because I want this to give a 100 percent oxygen so if my patients breathing back into the bag it's not going to get 100 percent oxygen so again both of these these are just different types of so these are called what they call bag-valve-mask Ambu bag resuscitator bag they're all the same

name for these things okay so what you're going to do is you're going to indicate the approximate volume when squeezing the Ambu bag so how you're going to do this is you're going to attach this barometer now be careful with this barometer because if you drop it it breaks so what I would suggest instead of holding it over the floor hold it over the counter okay and this button clears it and resets it to zero and you're going to squeeze with one hand or maybe you can have a partner holding this by you're going to squeeze with one hand and you're going to squeeze and reset it you're going to squeeze your two hands and you're going to see what the difference is in volume because what this does is this is measuring the volume of oxygen that's coming out of here so you're going to measure it so each time you do it you reset it here so all the way around is one liter but like to the point four that means it's 0.4 liters or 400 ml 0.7 is 0.7 liters or 700 ml all the way around is a liter or a thousand ml so you're going to use the rice formatter to measure one hand and then do two hands okay

different filters then the other thing is indicate the maximum flow meter setting for resuscitator bags maximum flow meter setting would be considered flush flush means above 15 liters so maximum flow meter setting would be flush which is above 15 liters now let's look at this resuscitator bag now compare the two what do you notice what's the difference between these two the size okay so why do you think there's two sides one exactly so this one would be you see how the mask is smaller so this would be used on a child this would be used on an adult so with children this has this is called a Popoff valve so with children once the pressure gets too high it won't allow you to go above a certain pressure once you hit that pressure air starts escaping around here so you cannot damage the child's lungs see once I squeezed too hard it starts to escape out around here around your Popoff valve P it escaping so what I'm excluding it so I can't go here take a big breath because then it starts to escape does this one have a Popoff now No so the question is which resuscitator

bags have a high-pressure Popoff valve pediatric resuscitator bang and then the next thing I'm going to have you do is I'm going to actually give you a filter and you're going to put it on the resuscitator bag okay and I want you to take a breath in and I want you to tell me does taking a spontaneous breath in open the valve so does the valve open so that's the next question but the only way you're going to know is you're going to actually use a filter you're to put the filter on here and you're going to take a breath in through the filter and you're going to tell me does the valve open because we know the valve opens when I squeeze it but we'll the what if the patients trying to take a breath will the valve open and give them a let them take oxygen or not so you'll have to see if that works then you're going to pressure check to check the bank to ensure there are no leaks how you pressure check a bag is you take off the mask so make sure the mask is off and you include the outlet port and you squeeze it you should not be able to squeeze it if there was a leak somewhere

in here you could squeeze it because air is because the air is not escaping because I have excluded so you see how I'm pressure checking it to make sure there's no leaks if I was able to squeeze it like this there's a leak I'm getting at a leak I guess I can't really see if I can if I can squeeze it there the lease someplace so that's how you're going to pressure check it check it then you're going to and you're patient so this is your patient you're going to put the mask on you're going to turn it on how about a few a flowmeter you're going to turn it on 15 liters or higher and you're going to manually resuscitate your patient now what if you want to make sure your patients is sniffing position so you don't want to hyper extend their neck then you're going to use the seee method remember the cee method for a blowing a patient so see is over the mask the three fingers are under the job okay and you're going to have this connected to a flow meter and then how am I going to know if I'm if it's working wow that's cool just right good so I

should see chest right okay what if I don't get chest right and that works you and go home right reach at the head position so maybe I don't have this head position so recheck the position make sure I have a good seal so I should get bilateral chest right okay so that's what you're going to do at the station so you're going to measure your one squeeze two squeezes the volume you're going to see if the valve opens up when you take a spontaneous breath and you're going to manually resuscitate your mannequin