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

Positive pressure ventilation

Ventilation of the lungs single most important and most effective step in

cardiopulmonary resuscitation of the compromised newborn

A good resuscitation bag

Size 200-750 ml Capable of avoiding excessive pressure

A pressure pop-off valve and/or a pressure gauge manometer

Capable of giving 100% oxygen Appropriate sized mask

Resuscitation bags

Two types Flow inflating bag (anesthesia bag) Self inflating bag

Flow inflating bag

Flow inflating bag

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 pressure-

inflation

Flow inflating bag will not work if

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 bagAdvantages

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 bagDisadvantages

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

Fill spontaneously after they are squeezed, pulling oxygen or air into the bag

Remain inflated at all times

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

Require attachment of an oxygen reservoir to deliver 100% oxygen

Without Reservoir

With Reservoir

Self inflating bagAdvantages

Does not need a gas source to inflate Pressure release valve Easier to use

Self inflating bagDisadvantages

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

oxygen

Masks

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

Correct position of mask

Testing the self-inflating bag Squeeze against your palm

Pressure felt Pressure release valve Pressure manometer Re-inflation