Positive pressure ventilation l Ventilation of the lungs

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Positive pressure ventilation l Ventilation of the lungs l single most important and most

Positive pressure ventilation l Ventilation of the lungs l single most important and most effective step in cardiopulmonary resuscitation of the compromised newborn

A good resuscitation bag l l Size 200 -750 ml Capable of avoiding excessive

A good resuscitation bag l l Size 200 -750 ml Capable of avoiding excessive pressure l l l A pressure pop-off valve and/or a pressure gauge manometer Capable of giving 100% oxygen Appropriate sized mask

Resuscitation bags l Two types l l Flow inflating bag (anesthesia bag) Self inflating

Resuscitation bags l Two types l l Flow inflating bag (anesthesia bag) Self inflating bag

Flow inflating bag

Flow inflating bag

Flow inflating bag l l Fill only when oxygen from a compressed source flows

Flow inflating bag l l Fill only when oxygen from a compressed source flows into them Depend on a compressed gas source Must have a tight face-mask seal to inflate Use a flow-control valve to regulate pressureinflation

Flow inflating bag will not work if l l The mask is not properly

Flow inflating bag will not work if l l The mask is not properly sealed over the newborn’s nose and mouth There is a tear in the bag The flow-control valve is open too wide. The pressure gauge is missing

Flow inflating bag Advantages l l Delivers 100% oxygen at all times Easy to

Flow inflating bag Advantages l l Delivers 100% oxygen at all times Easy to determine the adequacy of seal “Stiffness” of lungs can be felt Can be used to deliver 100% free flow oxygen

Flow inflating bag Disadvantages l l Requires a tight seal to remain inflated Requires

Flow inflating bag Disadvantages l l Requires a tight seal to remain inflated Requires a gas source to inflate No safety pop-off valve Requires more experience

Self inflating bag

Self inflating bag

Self inflating bag l Fill spontaneously after they are squeezed, pulling oxygen or air

Self inflating bag l Fill spontaneously after they are squeezed, pulling oxygen or air into the bag l Remain inflated at all times l Can deliver positive-pressure ventilation without a compressed gas source; user must be certain the bag is connected to an oxygen source for the purpose of neonatal resuscitation l Require attachment of an oxygen reservoir to deliver 100% oxygen

Without Reservoir

Without Reservoir

With Reservoir

With Reservoir

Self inflating bag Advantages l l l Does not need a gas source to

Self inflating bag Advantages l l l Does not need a gas source to inflate Pressure release valve Easier to use

Self inflating bag Disadvantages l l l Will inflate even without adequate seal Requires

Self inflating bag Disadvantages l l l Will inflate even without adequate seal Requires a reservoir to deliver 100% oxygen Can not be used to deliver 100% free flow oxygen

Masks l l l Cushioned/Non-cushioned Round/Anatomical shaped Size 0 or 1

Masks l l l Cushioned/Non-cushioned Round/Anatomical shaped Size 0 or 1

Correct position of mask

Correct position of mask

Testing the self-inflating bag l Squeeze against your palm l l Pressure felt Pressure

Testing the self-inflating bag l Squeeze against your palm l l Pressure felt Pressure release valve Pressure manometer Re-inflation

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