All About Ventilation During CPR
Adequate ventilation is an integral component of CPR. Whether you’re using basic or advanced techniques, ensuring the airway is open and effective oxygen delivery is occurring is important. Re-evaluating and reassessing the airway periodically ensures the best possible outcome.
Here are the main 7 points of the ventilation techniques in CPR:
Basic Airway Maneuvers
Head Tilt-Chin Lift: This opens the airway in unconscious patients. The tongue is lifted off the back of the throat by tilting the head backwards and lifting the chin upward, opening the airway.
Jaw Thrust: The jaw-thrust manoeuvre is used for trauma patients or those with a suspected spinal injury to avoid moving the cervical spine.
Mouth-to-Mouth Ventilation
This is a basic technique where a rescuer gives breaths by creating a seal with their mouth over the patient’s open mouth. The nose should be pinched shut during this process. And each breath should last about 1 second, making the chest visibly rise. Allow the breath to release after each rescue breath.
Bag-Valve-Mask (BVM) Ventilation
Professional healthcare providers most commonly use Bag-valve-mask or Bag-mask. It has a self-expanding bag, a one-way valve, and a mask. It is preferred over mouth-to-mouth because it delivers higher oxygen concentrations, and there’s no direct contact between rescuer and victim.
Advanced Airway Management
Endotracheal Intubation: This is where a tube is inserted into the trachea, providing a direct path for ventilation. It ensures the highest oxygen concentration delivery and protection against aspiration. However, it requires specialized training and has associated risks.
Supraglottic Airway Devices: Devices like the laryngeal mask airway (LMA) or King LT can be inserted into the oesophagus or over the glottis. These are alternatives to endotracheal intubation and can be quicker and easier to place, especially in challenging environments.
Confirmation of Placement: Regardless of the advanced airway method used, confirmation of its correct placement is critical. This can be done through clinical assessments (like watching for chest rise) and technological methods (like capnography).
Ventilation Rates:
Remember these 2 points while delivering rescue breathe:
- Before advanced airway placement: 30 chest compressions followed by 2 ventilations.
- After advanced airway placement: Continuous chest compressions at a rate of 100–120/minute, with ventilations given 10 times per minute without pausing compressions.
Considerations in Special Scenarios
Opioid Overdose: Patients with suspected opioid overdose might benefit from naloxone (Narcan) administration, rescue breaths, and other CPR steps.
Drowning: These victims might have water in their airways. It’s important to quickly turn the victim’s head to the side to let the water drain before starting ventilation.
Also learn: How to identify drowning victim
Use of Barrier Devices
Rescuers can use barrier devices like pocket masks or face shields to reduce the risk of disease transmission during mouth-to-mouth ventilation.
Conclusion
Proper ventilation during CPR ensures effective oxygenation and carbon dioxide removal. Whether utilizing basic mouth-to-mouth or advanced airway techniques, it’s vital to maintain an open airway and provide adequate breaths.
Continuous assessment and correct method application are essential to maximize the chances of a positive patient outcome.
Stay up to date with the AHA guidelines of CPR. American Heart Association updates their guidelines every 5 years, and the CPR certification should be renewed after 2 years. Get enrolled in a CPR recertification class with a reputed training centre.
Training centre like Heart Start CPR provides online and in-class courses for CPR, BLS, ACLS, PALS, Fire training and Stop The Bleed®.