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