Prehospital Ventilation is in the Bag with Proper Technique and Appreciation

As a 16-year-old observer on the ambulance with my father, I wasn't allowed to ventilate unconscious patients, but I watched and learned a great deal by just observing how they used their "football," an early Puritan Manual Resuscitator (PMR) bag-valve mask (BVM). They nicknamed it the "football" not just because it was brown and resembled a football, but because it was easier to tell the firefighters or police officers assisting them to "go get the football" than "go get the BVM." I was curious why my dad placed rolled towels or a blanket under the patient's shoulder blades and neck, and then placed his knee against the top of the patient's head that was extended back toward him. He explained that the padding raised the patient's upper torso and placed the patient into a head-back position that opened their airway like a "wide-open rain gutter." He added that the knee he placed against the patient's head helped keep their head from moving forward. Both actions optimized ventilation by keeping the airway of a non-traumatized patient open to its most effective position. It was an impressionable lesson I never forgot. After college I became an EMT but never really appreciated the importance of proper BVM ventilation until I entered paramedic training in Allentown, Pa., in 1977. Through no fault of their own, my EMT instructors, using an 81-hour curriculum, only had so much time to teach ventilation support with a BVM. Emphasis w...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Columns Source Type: news

Related Links:

This study aimed to determine the correlations between the craniofacial morphology and pharyngeal airway volume in patients with complete bilateral cleft lip and palate (BCLP). DESIGN: Retrospective study. SETTING: Tertiary hospital. PARTICIPANTS: Twenty-seven patients with complete BCLP and 27 class I control patients, aged 10 to 14 years. MAIN OUTCOME MEASURE: The pharyngeal airway volume and craniofacial morphology were evaluated using cone-beam computed tomography. Measurements were compared between groups and any correlations were identified. RESULTS: A significantly smaller total pharyngeal a...
Source: The Cleft Palate-Craniofacial Journal - Category: ENT & OMF Authors: Tags: Cleft Palate Craniofac J Source Type: research
Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tiss...
Source: Maxillofacial Plastic and Reconstructive Surgery - Category: ENT & OMF Authors: Tags: Research Source Type: research
Abstract Conventional in vitro tests to assess the aerodynamic particle size distribution (APSD) from inhaler devices use simple right-angle inlets ("mouth-throats", MTs) to cascade impactors, and air is drawn through the system at a fixed flow for a fixed time. Since this arrangement differs substantially from both human oropharyngeal airway anatomy and the patterns of air flow when patients use inhalers, the ability of in vitro tests to predict in vivo deposition of pharmaceutical aerosols has been limited. MTs that mimic the human anatomy, coupled with simulated breathing patterns, have yielded estima...
Source: Advanced Drug Delivery Reviews - Category: Drugs & Pharmacology Authors: Tags: Adv Drug Deliv Rev Source Type: research
CONCLUSION: The upper airway values did not show any significant discrepancies between the two groups during the observation period. CLINICAL SIGNIFICANCE: Functional devices were effective in solving class II relationships, but there is no evidence of successful breathing disorders prevention by using mandibular activators, probably due to the stability of airway tissues reached in pubertal age in both groups. PMID: 33025936 [PubMed - indexed for MEDLINE]
Source: J Contemp Dent Pract - Category: Dentistry Authors: Tags: J Contemp Dent Pract Source Type: research
ConclusionThe present study is a basic study demonstrating how different techniques of ESP affect the position of the soft palate. The PP –SPC attachment can be transected in the patients with anterior–posterior palatal and lateral wall collapse to pull the soft palate anteriorly in addition to prevent the lateral wall collapse. The PP–SPC attachment can be preserved in the patients with only lateral wall collapse. Nevertheless, the clinical consequences of these static changes need to be evaluated in clinical studies.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Authors: Matsui R, Wong M, Waters B Abstract Transoral application of a nasopharyngeal airway (NPA) is a novel technique for difficult airway management. Clinically, it is an effective alternative for use in nonintubated dental cases under total intravenous anesthesia. This technique can help improve oxygenation and ventilation in clinical situations in which the conventional use of NPAs is ineffective, such as in patients who have findings of obesity; mandibular retrognathia or hypoplasia; maxillary hypoplasia; macroglossia; nasal obstruction secondary to hypertrophic tonsillar, adenoid, and/or lymphoid tissues or...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
In the early twentieth century, many physician-anesthetists packed example(s) of an oropharyngeal airway in their toolboxes. Although metal varieties invented by Connell or Waters werestatus quo, these forced physicians to tolerate a patent but potentially traumatized patient airway in the form of bruised lips and chipped teeth. Enter Arthur E. Guedel, M.D. (1883 to 1956,left), with his “nontraumatic pharyngeal airway,” publicized in 1933 from his adopted hometown of Beverly Hills, California. Constructing his semicircular oropharyngeal airway of rubber that could flex to any individual’s anatomy, Dr. Gue...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
AbstractObjectiveDistraction osteogenesis maxillary expansion (DOME) is a reliable method to expand the nasal floor and hard palatal vault in adults with obstructive sleep apnea (OSA). DOME results in a reduction in the apnea-hypopnea index (AHI) and subjective report of improved nasal breathing. Using rhinomanometry augmented computational fluid dynamic (CFD) modeling, we propose a mechanism of how DOME reduces upper airway pharyngeal collapse in adults with OSA.Material and methodA retrospective cohort with 20 subjects and mean age of 29.6 ± 8 years who completed DOME at Stanford University from September 2014 to ...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Authors: Yu X, Wang J, Hou S, Zeng R Abstract Temporomandibular joint (TMJ) ankylosis in pediatric patients is rare and may cause severe micrognathia and obstructive sleep apnea syndrome. The present study reports on the treatment and 4-year follow-up of a pediatric patient with early-onset bilateral TMJ ankylosis and severe secondary micrognathia, as well as obstructive sleep apnea syndrome. A typical 'bird face' appearance was noted with severe mandible retrognathism and a significant convex facial profile. The treatment of this patient involved TMJ ankylosis release with condylectomy and simultaneous bilateral m...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Conclusions: The prototype VHC may provide a potential option for patients previously unwilling to carry more conventional VHCs with them, in order to give delivery assurance of their reliever medication.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
More News: Emergency Medicine | Lessons | Oropharyngeal Airway | Respiratory Medicine | Teaching | Training | Universities & Medical Training