Síguenos en Twitter       Síguenos en Facebook       Síguenos en YouTube       Siguenos en Linkedin       Correo Grupsagessa       Gmail       Yahoo Mail       Dropbox       Instagram       Pinterest       Slack       Google Drive       Print       StumbleUpon NEW


Mi foto
FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com



Buscar en contenido


domingo, 29 de enero de 2017

Abandon Face-Mask Ventilation?

ACEP Now - January 11, 2017 - By Richard M. Levitan
"Face-mask ventilation is considered a fundamental procedural skill in emergency medicine. We have historically deployed it when patients are apneic, are hypoventilating, or need assistance with oxygenation. We keep bag-mask units at the head of every bed in the emergency department.
The world of airway management has evolved since the self-inflating bag-valve mask (BVM) was first created more than 50 years ago. In elective anesthesia, the laryngeal mask airway (LMA) has entirely replaced face-mask ventilation as a strategy for airway and anesthetic management in cases with a low risk of aspiration. In fact, the laryngeal mask is now used in the majority of elective anesthesia cases worldwide. It also has a rapidly growing presence in the world of prehospital care, especially in the United Kingdom and Europe...
The role of face-mask ventilation in emergency situations is rapidly diminishing. I believe the first response to hypoxia should always be Os up the nose, either a standard nasal cannula combined with a non-rebreather to get flows >30 lpm or special high-flow, warm, humidified nasal cannula systems. Sit the patient upright as much as possible and pull on the mandible. In cardiac arrest, passive oxygenation and an LMA-type device should be used preferentially over bagging a patient in a flat position. If you have to use a face mask to provide PEEP (ie, BVM with a PEEP valve or continuous positive airway pressure mask), always do so in an upright position."