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Presentation on theme: "BAG & MASK VENTILATION."— Presentation transcript:


2 Indications Apneic or gasping following initial steps and tactile stimuloation HR<100/min in a spontaneously breathing baby Spontaneously breathing infant - cyanotic despite free flow oxygen

3 Contraindications Diaphragmatic hernia
Non -vigorous baby born through meconium stained liquor

4 Selecting bag & mask equipment
Size of bag ( ml): To deliver a tidal volume of 6-8 ml/kg Oxygen capability: Oxygen source, reservoir Safety feature: Pop off valve, pressure gauge (optional) Mask: Size 0 & 1 (Cover chin, mouth, nose), cushioned edges

5 Forming seal Positioning the infant Position of resuscitator

6 Forming & checking the seal
Positioning & holding the mask: Enclose chin, mouth & nose, ensure snug seal, avoid pressure over neck and eyes Squeeze the bag with finger tips: Don’t squeeze empty the bag with whole hand Observe chest movements: Noticeable rise and fall of chest, shallow and easy breathing

7 Ventilation rate and pressure
Rate : breaths/minute Squeeze-two-three-squeeze Pressure : Increase in HR &/or Noticeable rise and fall of chest Initial breath: cms H2O Later : cms H2O

8 Improvement Increasing HR Improving color Spontaneous breathing

9 No improvement / deterioration
Chest movement not adequate Inadequate seal Reapply mask Blocked airway Reposition Clear secretions Ventilate with open mouth Insufficient pressure Increasing pressure

10 Deterioration Check oxygen delivery system Oxygen supply Oxygen tubing

11 Orogastric catheter Indication Technique
Need for bag and mask ventilation for over 2 minutes Technique Use 6-8 Fr size, measure the length, aspirate gastric contents, leave outer end open

12 Preterm infants Avoid excessive chest wall movements (large tidal volume) Monitoring of pressure may help to provide consistent inflations and avoiding unnecessary high pressure CPAP after resuscitation may be helpful

13 Baby needs Bag and mask ventilation
Select bag and connect to oxygen source capable of giving 100% oxygen Select appropriate size mask Test bag Good pressure Pressure release valve working Pressure manometer cm H2O Baby needs Bag and mask ventilation Position yourself at head end or side of baby Position baby’s head in sniffing position Position bag and mask properly on baby Check easy chest rise during first two-three breaths

14 Bag and mask ventilation
Yes No Check for inadequate seal; reapply face mask Chest Rise Check for blocked airway. Reposition head, remove secretions, mouth slightly open Consider insufficient pressure. Increase pressure; consider intubation

15 Check heart rate with stethoscope or umbilical palpation for 6 seconds
Ventilate for 30 seconds Rate bpm Increasing HR, visible rise and fall of chest Check heart rate with stethoscope or umbilical palpation for 6 seconds Less than 6 beats (< 60bpm) 6-10 beats (60-100bpm) More than 10 beats (>100 bpm) Continue ventilation Initiate chest compression Consider intubation Continue ventilation Consider intubation Check for spontaneous breathing Yes No Gradually discontinue positive pressure ventilation Provide tactile stimulation Provide free flow oxygen Need of post-resuscitation care Continue positive pressure ventilation Consider intubation Consider OG tube insertion Need of post-resuscitation care

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