This is a Multi-Purpose Text Section
The bag-valve-mask, or BVM, is possibly one of the devices that is likely to be one of the most effective pieces of equipment in saving the patient’s life. However, unfortunately it is very often used with little to no training and as a consequence not very effectively (R. Levitan, 2004).
There is nothing more likely to induce a degree of panic in a stressful situation than if the person managing the airway is not able to ventilate the patient.
Ventilation of the patient is the most important part of the process of intubation. If you can ventilate then an inability to intubation becomes less of a problem. You can continue to ventilate, thereby supplying the patient with the much-needed oxygen, whilst you either seek further options or further help.
Commonly the bag valve mask is used incorrectly in a number of ways. The bag may be inflated too much and/or too often. The mask itself may not be applied to the patient’s face correctly, perhaps using an incorrect number of people or a grip which is not optimal. It may be that the patient’s head has not been positioned correctly, something which is vital to ensure that ventilation can occur.
Lets first begin by talking about the bag-valve-mask itself and its components
The masks themselves can come in a range of sizes and designs depending on whether the patient is an adult or a child, a large or a small person. The cuff around the mask is commonly inflated with air or made of a firm sponge-like material which is designed to mould firmly around the patient’s face.
They are independent of the bag and can be easily separated from it and replaced if necessary. This is a feature which we will come back to later on.
There is an oxygen inlet at one end with tubing attached. This can then supply the bag with oxygen thereby ensuring that the desired amount can be delivered to the patient. It is important when bagging the patient, especially if one has taken over the airway from someone who initiated it, that you are sure the tubing is attached to an oxygen supply and that you are not just delivering air.
There is an air intake valve at one end which is what allows the self-inflating bag to self-inflate.
There is an oxygen reservoir bag which has two one-way valves. This reservoir helps to ensure that the patient is breathing the maximum amount of oxygen available and if necessary rebreathing the minimum amount of their own gases. The inlet valve will ensure that room air can enter if the oxygen gas flow is too low, and the outlet valve will allow oxygen to escape if the pressure in the bag is excessive.
There is a standard 15 mm adapter for attaching to masks or the various tubes which may be in the patient’s mouth.