INDICATION
■ Relieve upper airway obstruction from tongue in the unconscious or semi-
conscious patient.
■ Adjunct to BVM ventilation
CONTRAINDICATION
■ The oropharyngeal airway should notbe used on the patient with an intact
gag reflex(risk of vomiting).
PROCEDURE
■ Oropharyngeal airway
■ Insert the device while inverted →rotate 180° once well into the
mouth→advance distal end into the hypopharynx.
■ This technique is not recommended for pediatric patients.
■ Orcompress the tongue with a tongue depressor and advance the
device without inversion.
■ Nasopharyngeal airway
■ Gently advance into a nostril until the flared end is resting against the
nasal orifice.
COMPLICATIONS
■ Epistaxis (nasopharyngeal airway)
■ Vomiting and aspiration
■ Worsened obstruction from improper placement (oropharyngeal airway)
BAG-VALVEMASKVENTILATION
INDICATION
■ Inadequate oxygenation or ventilation, as bridge to intubation
PROCEDURE
■ Open airway via jaw thrust and naso- or oropharyngeal airway.
■ Position mask to cover mouth and nose.
■ Single-handed mask hold: Thumb and index fingers on mask with
remaining fingers wrapped around mandible. This is a difficult tech-
nique but may be necessary for a single rescuer.
■ Two-handed technique: Thumb and index fingers on either side of
mask with remaining fingers wrapped around mandible.
■ Lift mandibleinto mask to form seal.
■ Two-handed mask hold obtains better seal!
■ Squeeze bag and administer volume necessary to achieve chest rise.
■ Verify oxygen flow rate of 15 L/min.
■ Avoid pop-off valves (if present).
COMPLICATIONS
■ Inadequate mask seal
■ Inadequate ventilation
■ Gastric distention →emesis and aspiration.
■ Insufflation of vomitus/blood/debris into trachea
RESUSCITATIONIf you can’t bag a patient, add
naso- and oropharyngeal
airways, reposition head, and
try again.A patient who easily tolerates
an oral airway needs
intubation.What is the appropriate
volume to administer with
BVM? One that achieves
chest rise.Avoid pop-off valves as airway
pressure in emergency
conditions often exceeds the
valve pressure.