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Old 08-26-2011, 10:14 AM   #1
traumaluv2011
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Artificial Ventilations


I was wondering what other EMTs prefer to use. I was reading up on the airway chapter and I saw an interesting comparison between the two. I would think the best method is to use a BVM based on the ability to use oxygen if available. However, say someone with a basic jump bag came upon an apneic patient as a first responder and they had both a pocket mask with one way valve or a BVM to choose from.

My book said that manual artificial respiration gives about 16% oxygen per ventilation while a BVM gives 21%. But the manual would give you more tidal volume. So is it better to have more oxygen or have more air going through the lungs?

I would think more oxygen would seem like the better option.



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Old 08-26-2011, 10:23 AM   #2
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If I had to choose between a mask or a BVM, it's ALWAYS a BVM.

I'm guessing you're new. Wait 'til you're ventilating a puking person.

BVM always wins.


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Old 08-26-2011, 11:47 AM   #3
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BVM no question.

However, if you're not used to using one and have no experience managing an airway you are more likely to be able to use a pocket mask more effectively, especially if you're alone. Much as they look intuative - mask over mouth & squeeze bag - they actually take a fair bit of practice (on a variety of people) before you can be confident about being able to open the airway adequately, get a good seal and ventilate an appropriate volume at an appropriate rate.

As for your question about oxygen versus volume. Vt is nice to have but it doesn't increase oxygenation in itself, for that you really need a higher fraction of inspired oxygen (i.e 0.21 instead of 0.16) or that oxygen needs to spend longer in the lungs (either positive end expiratory pressure or a lower inhalation to exhalation ratio).
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Old 08-26-2011, 12:15 PM   #4
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Also, increased volume tends to increase the risk of not only gastric insufflation but also damage to the lungs by way of overinflation of the alveoli. As was said before, BVM over pocket mask any day.
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Old 08-26-2011, 12:37 PM   #5
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no question. B V M.
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Old 08-26-2011, 09:12 PM   #6
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Originally Posted by n7lxi View Post
i'm guessing you're new. Wait 'til you're ventilating a puking person.

Bvm always wins.

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Old 08-26-2011, 10:24 PM   #7
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BVM, provided you can competently use it and make a seal. Otherwise pocket mask.

Last edited by ArcticKat; 08-26-2011 at 10:29 PM.
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Old 08-26-2011, 10:53 PM   #8
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Yea, I'm pretty new to the field. Just got certified a month ago. Thank you for the answers. I will definitely go for a BVM if possible.
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Old 08-27-2011, 01:48 AM   #9
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BVM, otherwise I may get dizzy. I also don't like my own vomit, much less someone elses.
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Old 08-27-2011, 02:23 AM   #10
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Bag valve. Hands down. After a bit of practice and practical application in the field, you'll be able to use a BVM as, if not more, effectively than a face mask. I know I should jinx myself, but I've never had call to use my face mask. I've always been able to reach the BVM just as quickly.

Alpha, I know what you mean about vomit. Also, my instructor forever scared me about using a face mask when he told a story about a malfunctioning one way valve allowed a patient to puke into, and fill his mouth up with, vomit. I almost lost it listening to that story. :-S
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