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Chapter 12 - Face Mask Ventilation

from Section 1 - Airway Management: Background and Techniques

Published online by Cambridge University Press:  03 October 2020

Tim Cook
Affiliation:
Royal United Hospital, Bath, UK
Michael Seltz Kristensen
Affiliation:
Rigshospitalet, Copenhagen University Hospital, Denmark
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Summary

Face mask ventilation is a basic skill taught to and practised by a large array of medical practitioners. It is usually the first technique applied to an unconscious patient or victim that is unable to generate effective oxygenation and ventilation. Although it is considered a simple technique its outcome is often suboptimal. This chapter describes face mask ventilation devices, techniques and the concept of difficult face mask ventilation. The one- and two-hand face mask ventilation are reviewed in the context of the airway manoeuvres used to address the upper airway obstruction of the supine unconscious patient: head extension, jaw thrust and the triple airway manoeuvre. The concept of measuring the adequacy of face mask ventilation using known objective ventilation outcome markers (tidal volume, airway pressure and the capnogram) is introduced to contrast with the routine unreliable subjective markers (cyclical condensation of the mask dome and bag compliance). Reassessment of face mask ventilation technique using objective ventilation markers is encouraged to further optimisation of the outcome. The predictors and the management of face mask difficulty is examined from a practical point of view.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Fei, M, Blair, JL, Rice, MJ, et al. (2017). Comparison of effectiveness of two commonly used two-hand mask ventilation techniques on unconscious apnoeic obese adults. British Journal of Anaesthesia, 118, 618624.CrossRefGoogle Scholar
Kuna, ST, Woodson, LC, Solanki, DR, et al. (2008). Effect of progressive mandibular advancement on pharyngeal airway size in anesthetized adults. Anesthesiology, 109, 605612.CrossRefGoogle ScholarPubMed
Langeron, O, Masso, E, Huraux, C, et al. (2000). Prediction of difficult mask ventilation. Anesthesiology, 92, 12291236.CrossRefGoogle ScholarPubMed
Lim, KS, Nielsen, JR. (2016). Objective description of mask ventilation. British Journal of Anaesthesia, 117, 828829.CrossRefGoogle ScholarPubMed
Matioc, A. (2019). An anesthesiologist’s perspective on the history of basic airway management. The ‘modern’ era, 1960 to present. Anesthesiology, 130, 686711.CrossRefGoogle ScholarPubMed
Paal, P, Goedecke, V, Brugger, H, et al. (2007). Head position for opening the upper airway. Anaesthesia, 62, 227230.CrossRefGoogle ScholarPubMed

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