Exhaling During Manual Ventilation Is As Important As Inhaling

One of my readers recently asked a very important question about ventilating a patient with a bag-valve-mask device: “Is there an outlet for the expired air of the patient?” The answer is yes. When ventilating a patient we are concentrating, and rightfully so, on watching the lungs expand and verifying that we hear breath sounds. It is just as important to verify that your patient can exhale. All ventilation devices have a built in pressure relief valve, also called a pop-off valve, which allows you to balance the force needed to expand the lungs with the ability to the patient to passively exhale. Failure to allow exhalation can lead to patient injury from barotrauma. Read More …

Communication In A Crisis: A Case of Respiratory Depression In A Child:

When I’m teaching airway management to my Perioperative/OR nurses, I often recount the story of management of a young child’s postoperative respiratory depression. In addition to illustrating the importance of evaluating ventilation in addition to oxygenation, this case shows how good communication makes management of a critical event more effective. Read More …

Airway Emergency: Start With The Basics of Airway Management

A case of “can’t intubate- can’t ventilate is discussed which illustrates the importance of always using good techniques of basic airway management. Read More …

Difference in Manual Ventilation: Self-Inflating Ventilation Bag vs. a Free Flow Inflating Bag

Ventilating with a bag-valve-mask device requires a good mask seal against the face in order to generate the pressure to inflate the lungs. But it also requires knowledge of how to effectively use the ventilation device to deliver a breath. This article discusses the difference in the use of a self-filling ventilation bag and a free-flow ventilation bag. Read More …

Airway Obstruction Can Occur After Thyroglossal Duct Excision

Airway obstruction can occur following uneventful thyroglossal duct excision because of removal of the hyoid bone. This article describes reasons why the anatomical change can cause obstruction and discusses a case where such airway obstruction needed treatment in the immediate postoperative period. Read More …

Getting A Good Mask Seal When Ventilating a Patient

Use of a bag-valve-mask device is one of the most important skills you can master in patient care. Many of my students have a hard time ventilating with a bag-valve-mask device because they fail to get a good seal with the mask. So let’s discuss how to place the mask step-by-step. Read More …