Abstract
Effective mask ventilation is an essential skill for any practitioner engaged in airway management. Recent methods to objectively describe mask ventilation using waveform capnography help practitioners to monitor and communicate the effectiveness of mask ventilation. Gentle mask ventilation is now considered acceptable during rapid sequence induction/intubation after loss of consciousness, hence reducing the incidence of hypoxia prior to tracheal intubation. Mask ventilation can be enhanced with muscle relaxation, a double C-E grip, and jaw thrust. This is particularly relevant for patients with reduced apnoea time. An awareness of the complications associated with mask ventilation may help reduce the morbidity associated with this technique. Effective ventilation technique and optimum device selection are important aspects for resuscitation of the newborn. Teaching correct establishment and maintenance of mask ventilation is essential for safe patient care. This review will examine some of the latest developments concerning mask ventilation for adult and paediatric patients.
Highlights
Effective mask ventilation is an essential skill for any practitioner engaged in airway management
Describing mask ventilation Given the significance of mask ventilation (MV), it is important to be able to measure and objectively describe the outcome of this procedure
In a Japanese Society of Anaesthesiologists airway management guideline, it was proposed that three distinct capnogram waveforms could be used to grade ventilation during MV1
Summary
F1000 Faculty Reviews are written by members of the prestigious F1000 Faculty. They are commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. A case of a faulty non-rebreathing patient valve led to excessive positive end expiratory pressure (PEEP) and inspiration without expiration, causing excessive intrathoracic pressure The implications of this included decreased lung compliance, high inspiratory pressure, high airway resistance, and a pneumomediastinum. The other study found that both a mask leak and airway obstruction were common during MV with PPV using a T-piece and a self-inflating bag These problems can be recognised and corrected by using a respiratory function monitor (RFM) which displays gas flow, tidal volume, and pressure waves[27]. An optimum MV technique has been devised based on a literature review and the development of a conceptual framework This approach addresses MV in terms of inadequate mask seal, increased airway resistance, and decreased respiratory compliance. Training accurate respiratory rates during paediatric MV can be improved with the use of a metronome[34]
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