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Delivering Free-flow Oxygen. Oxygen mask Flow-inflating bag and mask T-piece resuscitator Oxygen tubing. Free-flow Oxygen Given Via Oxygen Mask. Free-flow Oxygen Given Via Oxygen Mask. Free-flow Oxygen Given Via T-piece Resuscitator. Free-flow Oxygen Given Via Oxygen Tubing.
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Delivering Free-flow Oxygen Oxygen mask Flow-inflating bag and mask T-piece resuscitator Oxygen tubing
Types of Positive-Pressure Devices • Self-inflating bag • Flow-inflating bag (anesthesia bag) • T-piece resuscitator Types of Positive-Pressure Devices
Safety Features: Self-inflating Bags With Pressure-release Valve
Resuscitation Masks • Rim - Cushioned - Non-cushioned • Shape - Round - Anatomically shaped • Size - Small - Large Resuscitation Masks
Disadvantages • If the correct size is not selected, a seal can not form • If the mask is too large, eye damage may develop Resuscitation Masks: Round Shape
Advantages • Easier to obtain a seal • Less chance of eye damage Resuscitation Masks: Anatomically Shaped
Size • Small • Large Mask should cover • Tip of chin • Mouth • Nose Resuscitation Masks
The correct size will cover the tip of the chin, the mouth, and the nose but not the eyes. • Too large → Eye damage • Too small → Will not cover the mouth and nose and may occlude the nose. Resuscitation Masks: Size
Bags used for newborns should have a volume of 200 to 750 mL. Term neonates only require 15 to 25 ml with each ventilation (5-8 mL/kg). Size of Bag
Before beginning PPV: • Select appropriate-sized mask • Be sure airway is clear • Position baby’s head • Position yourself at baby’s side or head Preparation Checklist
Ventilation Rate 40-60 breaths per minute
Signs of Improvement Improvement is indicated by the following signs: • Increasing heart rate • Improving color • Spontaneous breathing • Improving muscle tone Signs of Improvement
Infant Not Improving and Chest Not Adequately Expanding Possible causes Inadequate seal Blocked airway Inadequate pressure
Causes and Solutions for Inadequate Chest Expansion Reapply mask to face
Causes and Solutions for Inadequate Chest Expansion Lift the jaw forward
Orogastric tube should be inserted to relieve gastric distention Gastric distention may • Elevate diaphragm, preventing full lung expansion • Cause regurgitation and aspiration Continued Positive-Pressure Ventilation
Equipment • 8F feeding tube • 20-mL syringe Insertion of Orogastric Tube
Insertion of Orogastric Tube Measuring correct length
Insert tube through mouth. Resume ventilation • Attach 20-mL syringe and aspirate gently • Remove syringe and leave tube end open to air • Tape tube to newborn’s cheek Insertion of Orogastric Tube Insertion of Orogastric Tube