Using the Ventilator as a Bag

Scott Weingart in this article advocates that rather than using the BVM to reoxygenate post failed intubation why not just connect the ventilator to the mask you are holding on the patient’s face instead of the bag?

Pros:

– can set a slow effective respiratory rate eg 10-12 breaths per minute.

– can set the appropriate tidal volume/rate of inspiration to avoid over-inflation, barotrauma and gastric insufflation

When the adrenaline is surging the airway doctor frequently bags with high volumes and at high rates – sometimes as high as 60 breaths per minute. This can lead to complications without any improvement in oxygenation.

Cons:

– it adds the element of a more complex equipment failure problem if the ventilator malfunctions, however one can always revert to traditional BVM.

– the intubator needs to be skilled in ventilator management and troubleshooting though one could argue that should the case anyway

 

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