Podcasts about bag valve mask

Outcomes With the Use of Bag–Valve–Mask Ventilation During Out‐of‐hospital Cardiac Arrest by SAEM

While emergency medical services (EMS) often use endotracheal intubation (ETI) or supraglottic airways (SGA), some patients receive only bag–valve–mask (BVM) ventilation during out‐of‐hospital cardiac arrests (OHCA). Our objective was to compare patient characteristics and outcomes for BVM ventilation to advanced airway management (AAM) in adults with OHCA.

Now that we've gone over the Modes & Settings, let's start talking about some of the most common alarms, what they mean, and what we could do about them as registered nurses. There is one alarm in particular, Peak Pressure (High Airway Pressures), that has the potential to lead to an airway emergency. I outline a systematic approach to assess the situation; how to escalate, and how to overcome. The key messages are: - If you're ever unsure: Ask - If the ventilator continues to peak pressuring, the patient is not ventilating during that time - If in doubt, call for back up, and hand bag the patient using the Bag Valve Mask attached to Oxygen 15L/min.

This is the second episode of the podcast, this time focusing on the sick patient. Apologies for the presenter - the pro (Matilda) will resume shortly. Markus is an intensive care specialist and anaesthetist in Dunedin, as well as an avid triathlete.FiO2:PaO2 calculator: can enter both mmHg and KPaVentilator guideFront of neck access.Steve Withington shares Ashburton's thoughts:Rural Hospitals have been very busy so far in the NZ fight against COVID, though reporting so far disguises this, as all is at DHB level. In Ashburton so far we have been mostly in preparation mode. One recent rural modification we have made that might work for you is repurposing our operating theatre. We have no negative pressure rooms in Ashburton, which is not ideal in times of COVID, particularly for aerosol generating procedures. However, our operating theatre – which in recent times has only been used for elective gastroscopy procedures (now suspended) – has, like all theatres, a positive pressure ventilation system. Our engineer has kindly reverse engineered this (And assures me it is not that hard), converting it to a negative pressure environment. That will allow us to perform more high risk procedures, like intubation, in that environment without risk of contaminating elsewhere in the admitting unit.A recent EMRAP (https://www.emrap.org/episode/emraplivecovid1/emraplivecovid) discussion of COVID-19 and airway management discussed a number of issues relevant to rural hospitals, for example, what to do when the ventilators run out, and we are left with the patients in rural. High flow nasal O2 is probably not as concerning as we think for aerosolisation and risk to staff, but, in a negative pressure environment, with appropriate PPE, this may result in bridging of time to ventilation. Similarly, using CPAP, may buy some time though the window may also be very short and transfer arrangements need to be discussed urgently. It seems that higher pressures than usual, are important in recruitment of small airways in the COVID-19 lung disease, and may extend the usefulness of CPAP, both in pre-oxygenation and potentially maintaining someone for a while.One method of providing CPAP in an ongoing way, without using up our one NIV machine, is to connect a CPAP mask with a Bag Valve Mask (connected to high flow O2) via a viral filter, pressuring the line with O2 (6 l/min) via the CO2 port, and using a PEEP valve on the BVM, titrated up higher than usual, as necessary (to 15-18cm) (https://emcrit.org/pulmcrit/cpap-covid/). No machine so less staff-intensive. We hope this will prove a viable way to look after a cohort of sick people in a time of restrictive ICU spaces, but at least it may help with pre-oxygenating someone prior to intubation. With a well-fitting CPAP mask the risk of aerosolisation should be small (but we should use N95 masks around these people for sure). Low threshold for some ketamine dissociative dosing to stop lots of coughing, fighting the mask, and risking infection control breaches.There has been a lot of discussion around PPE, and clearly intubation needs the highest level of protection: with N95 masks, full visor, neck protection, gown, gloves, viral filters, and also videolaryngoscopy if possible – to maintain maximum feasible distancing from the infected airway. Having someone supervise the removal of PPE after procedure is finished is crucial as this is probably as risky a procedure as the intubation itself. Evidence from Singapore on PCR testing of air and environmental samples in 3 symptomatic patient rooms for PCR detection supports continued use of surgical masks as aerosolisation was not detected, though environmental contamination highlighted the importance of PPE and regular cleaning. (https://jamanetwork.com/journals/jama/fullarticle/2762692).I'm keen to hear if people have rural hospital related issues with COVID-19 so I can try to escalate these to the Ministry of Health via the College. And let's keep sharing potential solutions as we find them that work for our environments.Cheers, Steve (steve.withington@cdhb.health.nz)

PEC Podcast Small Batch Interview! Have you ever heard of the dangerous Gorilla Grip ventilation technique? In this Small Batch, the PEC podcast crew discusses ventilation and the gorilla grip with:   Jeffrey Siegler MD @JeffreySiegler Melissa Kroll MD @Krollomd about their manuscript Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask? Click here to download now! We hope you enjoy this podcast and THANK YOU For listening! Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio DO (@PEMems)

Vito (@papaviitz ) joins me to discuss the opioid crisis in North America.  We cover the history of opioid use in our culture, both medically and recreationally. This includes the factors that caused this epidemic to get worse over the last 30 years.  The complexity of addiction and how opioids work on the brain are also discussed to help educate those who are curious. This includes how to recognize and respond to an overdose, using naloxone/narcan. Overdose and suicide are the leading causes of death in North America, higher than car accidents and heart disease.  Opioid overdoses are on the rise due to many complex factors, such as over-prescription of pharmaceutical painkillers and synthetic versions being laced into street heroin. In the 1960s 80% of heroin users started with heroin.  In 2019, 80% of heroin users started because of a prescription painkiller.  Therefore, physicians are now limited in prescribing painkillers in Canada and many states.  *When opioids overwhelm the receptors in the brain, they suppress the central nervous system. They can fully lose consciousness, pupils may constrict to pinpoint size, breathing stops or becomes ineffective, the skin goes very pale or blue/purple.  This will lead to death if it is not reversed immediately! Play video of opioid overdose: https://www.youtube.com/watch?v=RL4-Umip_Cc Overdose First-Aid Signs/symptoms of an overdose: -Blue/purple colour around face and lips -gurgling or loud snoring sounds -Unresponsive to shouting and shaking or aggressively rubbing sternum with knuckles -Ineffective breathing or not breathing at all First-Aid: Shout their name and shake their shoulders if the scene is safe Call 9-1-1 if they are unresponsive Give Narcan/naloxone (one dose of nasal spray or muscular injection) Perform rescue breathing by pocket mask and/or chest compressions If there is no improvement after 2-3 minutes, repeat steps 3 and 4. Stay with them. If the person begins breathing on their own, or if you have to leave them on their own, put them in the recovery position.  There is a high chance of vomiting and withdrawal, monitor ABCs. *Healthcare Providers (HCP): Airway management and ventilation by Bag Valve Mask with oxygen; only beginning chest compressions if NO pulse! The “Good Samaritan Drug Overdose Act” provides some legal protection for people who experience or witness an overdose and call 9-1-1 for help: https://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/about-good-samaritan-drug-overdose-act.html#a2  * Instagram: @jake_flightofthoughts * Facebook Community Group: The Psychedelic Society of First Responders and Emergency Workers * This podcast is uncensored and covers many topics considered “taboo” or difficult for some individuals. We do not condone any illegal activities, as this is a platform for harm reduction and open-dialogue.  Although the ideas are mostly evidence-based and honest, the lines of reality and comedy may be blurred at times...this is your trigger warning!

This week we continue our discussion (started several years ago) on the most important procedural skill set in Emergency Medicine…. Airway!

How do you oxygenate a patient (while you are preparing for RSI) if suction, moving the tongue, and basic BVM ventilation are unsuccessful? Pharyngeal Airways These tools bypass the posterior portion of the tongue to help with BVM ventilation Nasopharyngeal Airway (NP) Measure from earlobe to tip of nose TEST QUESTION: Don't use in a […]

Prehospital Emergency Care Podcast Episode XXII Happy Saint Patrick's Day Everyone! Do we have an episode for you!  We realize we've been doing specials for the past three months, but we now bring you back to your regularly scheduled program! Click here to download now. In this episode we will review TWO PEC Journals: The November 2016 PEC Journal  & The January 2017 PEC Journal   As a result, we have a PLETHORA of interviews for you! So without further delay here is the line up!   Police Officers Can Safely and Effectively Administer Intranasal Naloxone [1:57] Rian Fisher MD   Prehospital Medical Planning for the 2015 Philadelphia Papal Visit [10:12] Crawford Mechem MD   Recognition of Stroke by EMS is Associated with Improvement in Emergency Department Quality Measures [19:02] Michael E. Abboud MD   Quantitative Analysis of the Content of EMS Handoff of Critically Ill and Injured Patients to the Emergency Department  [31:50] Scott A. Goldberg MD, MPH     Continuous Quality Improvement Efforts Increase Survival with Favorable neurologic Outcome after out-of-hospital Cardiac Arrest [24:10] Karl Sporer MD     Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask? [40:12]   Jeffrey Siegler MD & Melissa Kroll MD      Please enjoy this interview-packed episode and stay tuned for our April PEC Podcast coming out next month! Thank you so much for listening and be safe everyone! Hawnwan Philip Moy MD Scott Goldberg MD Jeremiah Escajeda MD Joelle Donofrio DO  

Today I want to talk about proper ventilation with a Bag-Valve-Mask, aka the BVM. I am joined by my friend Reuben Strayer, MD of EM Updates. You'll see Reub's talk from this year's EMCrit ED Critical Care Conference and hear some of my thoughts as well.