Infant Bag Valve Mask (BVM) - Which One Is The Best?
Summary
TLDRThe video script reviews different types of bag-valve-mask (BBM) devices, focusing on the Mercury Medical Infant VVM and the Laradoll Bag. The speaker prefers the latter for its suitability in resuscitation, equipped with a peep valve and manometer for pressure control. The Kiraplex BBM from Bound Tree is highlighted for its innovative features, including a secure oxygen connection and a built-in manometer, making it the top choice for resuscitation scenarios.
Takeaways
- 🤱 The Mercury Medical Infant BVM is more set up for resuscitation, while the Laerdal bag seems more suited for CPR training.
- 🚫 The Laerdal bag lacks a PEEP valve and manometer attachment points, which are essential for resuscitation.
- 🫁 The Mercury Medical BVM comes with a spot for a PEEP valve and manometer, making it more versatile and reliable for resuscitation.
- 🧰 The need to assemble components on the Laerdal BVM could be problematic during an emergency, as it is less ready-to-use than the Mercury Medical one.
- 🌬️ The pop-off valve on the Mercury Medical BVM is set to 40 cm of water pressure, which prevents excessive pressure during ventilation.
- 📊 The manometer on the Mercury BVM is essential for controlling the amount of pressure when resuscitating infants, to avoid exceeding safe limits.
- 🧵 Corrugated tubing on some BVMs (e.g., Laerdal) lacks visual feedback, making it difficult to verify oxygen flow during resuscitation.
- 🎯 The Bound Tree Kiraplex BVM features a screw-on oxygen connection that prevents accidental disconnections, enhancing its reliability during resuscitation.
- 👜 The Kiraplex BVM has an integrated manometer and a pop-off valve set to 25 cm of water pressure, which is considered a safer limit for infants.
- 🔄 The ability to use different sizes of PEEP valves on the Kiraplex BVM adds flexibility, ensuring compatibility even when the ideal valve isn't available.
Q & A
What are the two types of BBMs discussed in the script?
-The two types of BBMs discussed are the Mercury Medical Infant VVM and the Laradoll Bag.
Which BBM does the speaker prefer for resuscitation and why?
-The speaker prefers the Laradoll Bag for resuscitation because it comes more set for resuscitation, with features like a built-in peep valve and manometer attachment point.
What is a potential use for the Mercury Medical BBM mentioned in the script?
-The Mercury Medical BBM might be suitable for CPR classes because it lacks a peep valve and manometer, which could be seen as simpler for training purposes.
What is a self-inflating bag and how does it function?
-A self-inflating bag is a type of BBM that automatically inflates with oxygen when the oxygen supply is connected, allowing for the delivery of breaths without needing to squeeze the bag.
What is a peep valve and why is it important in resuscitation?
-A peep valve is a device that helps maintain continuous positive airway pressure during mechanical ventilation. It is important in resuscitation to ensure proper oxygenation and prevent alveolar collapse.
What is the purpose of a manometer in a BBM?
-A manometer in a BBM is used to measure and control the amount of pressure being delivered during ventilation, which is crucial for safely managing the patient's airway pressure.
What is the pop-off valve and how does it work?
-The pop-off valve is a safety feature that sets a maximum pressure limit. When the pressure exceeds this limit, the valve opens to prevent over-inflation and potential damage to the patient's lungs.
Why does the speaker prefer a reservoir bag over corrugated tubing in a BBM?
-The speaker prefers a reservoir bag because it provides a clear visual cue of oxygen flow and bag inflation, which is important during resuscitation when auditory cues might be missed.
What is the significance of the oxygen tubing design in the Laradoll BBM?
-The oxygen tubing design in the Laradoll BBM is beneficial because it can connect directly to the oxygen source or to a 'Christmas tree' adapter, providing flexibility and a fail-safe in case of single patient use oversight.
What is the Kiraplex BBM and what makes it stand out according to the speaker?
-The Kiraplex BBM is another type of resuscitation device that the speaker finds to be possibly the best on the market. It stands out due to its secure oxygen connection, built-in manometer, adjustable pop-off valve, and versatile peep valve attachment.
Why is it important to avoid high pressure during pre-oxygenation in children?
-High pressure during pre-oxygenation can cause the esophageal sphincter to open, leading to gastric insufflation and a drastically increased risk of aspiration.
Outlines
👶 Comparing Infant Resuscitation Bags
The script begins with a comparison between two infant resuscitation bags: the Mercury Medical Infant VVM and the Laradoll Bag. The speaker prefers the latter for its suitability in resuscitation, as it lacks the need for additional accessories like a peep valve or manometer. The speaker also mentions a preference for the Laradoll Bag's self-inflating feature, its built-in peep valve attachment, and the convenience of its manometer slot. The pop-off valve is highlighted for its safety feature, preventing pressure from exceeding 40 cm of water, which is crucial during neonatal resuscitation.
🌬️ Oxygen Tubing and Reservoir Bag Preferences
The second paragraph discusses the importance of oxygen tubing and reservoir bags in resuscitation bags. The speaker favors tubing that can be directly attached to an oxygen source, mentioning a fail-safe design that can be used in the absence of a 'Christmas tree' oxygen connector. The paragraph emphasizes the need for careful pre-oxygenation to avoid gastric insufflation and the risk of aspiration. The speaker introduces the Kiraplex BBM, praising its secure oxygen connection, dual adapter, and built-in manometer. The pop-off valve is noted for its lower setting of 25 cm of water, aligning with safety recommendations for pediatric resuscitation.
🛠️ Advanced Features of the Kiraplex BBM
In the final paragraph, the speaker elaborates on the advanced features of the Kiraplex BBM, including its versatile peep valve attachment, which can accommodate different sizes. The speaker appreciates the mask's adjustable volume feature and the overall robustness of the device's construction. The summary concludes with the speaker's anticipation of using the Kiraplex BBM in simulations, suggesting it to be the best bag for resuscitation due to its safety features, ease of use, and adaptability.
Mindmap
Keywords
💡BBM
💡Mercury Medical Infant VVM
💡Resuscitation
💡PEEP Valve
💡Manometer
💡Pop-Off Valve
💡Corrugated Tubing
💡Oxygen Reservoir Bag
💡Kiraplex BBM
💡Pre-oxygenation
💡Esophageal Sphincter
Highlights
Comparison of two different types of BBMs: Mercury Medical Infant VVM and Laradoll's Bag.
Preference for the Laradoll's Bag due to its setup being more suitable for resuscitation.
The Mercury Medical BBM lacks a peep valve and manometer, requiring additional pieces for functionality.
Laradoll's Bag comes with an attachment for a peep valve, enhancing its readiness for use.
Bound Tree's BBMs come pre-equipped with a peep valve, which can be removed if zero peep is desired.
Importance of having a manometer for controlling pressure, especially in infant resuscitation.
The pop-off valve in Laradoll's Bag is set to 40 cm water pressure to prevent over-inflation.
Explanation of how to deliver higher pressure breaths in neonatal resuscitation when necessary.
Dislike for corrugated tubing as a reservoir bag due to lack of visual cues during resuscitation.
Advantages of a reservoir bag for visual indication of oxygen flow and bag inflation.
The importance of oxygen tubing that can connect directly to the oxygen source or a Christmas tree.
Risk of gastric insufflation and aspiration when ventilating kids with too much pressure.
Introduction of the Kiraplex BBM and its innovative features for resuscitation.
Kiraplex BBM's oxygen connection that cannot be accidentally pulled off, enhancing safety.
Dual adapter feature of the Kiraplex BBM for versatile oxygen source connection.
Kiraplex BBM's pop-off valve set to 25 cm water pressure, considered optimal for preventing esophageal sphincter opening.
Built-in manometer in the Kiraplex BBM for accurate pressure control without the risk of detachment.
Kiraplex BBM's adaptable peep valve attachment capable of fitting any size valve.
Adjustable mask volume feature in the Kiraplex BBM for precise ventilation.
Transcripts
so we're going to look at a couple
different types of bbm this is the
mercury medical infant vvm
and then this one is by laradol it's
called uh the bag
they're both 180 ml single hand squeeze
volumes if i had to pick right now which
one i would use
it would definitely be this one it comes
more set for resuscitation
this one looks like it is um i don't
know like probably like for cpr classes
or something
because it doesn't have a spot for a
peep valve it doesn't have a spot for a
manometer and i think if you want those
things there's probably this additional
little piece you can buy but anytime you
have to put together lego pieces uh to
to use a bbm it's probably not going to
be something that you're going to be
able to do in like the event of a
resuscitation so
i'm going to put this one aside there's
one thing i do like
better about this one than the the
mercury medical one
and i'll tell you what that is here in
just a second so let's take a look at
this so we have uh the bag here right
this is a self-inflating bag is what
they call it
and over here you can see it's already
got the attachment for a peep valve so i
don't have to put anything else on
except the peep valve and the ones from
bound tree which i'm trying to get a
hold of one and i'll do a review of that
one the ones from boundary
already come with the peep valve on like
this
so you'd have to actually take it off if
you didn't want peep and that's an
important point like if you wanted zero
of peep which you know i'm not sure why
but if you wanted zero if it was like an
asthmatic or something like a baby
asthmatic the only way to get zero is
not to take this until it doesn't turn
anymore it's to actually just pull this
off but during the pre-oxygenation
period
you're gonna want that you're going to
want that on and at least at 5 i would
say
now right up here this bag is going to
come with a manometer it's got a nice
spot here so if you take this cap off
i can take the manometer and it sits
right into here
so you can see i'll put it right up to
the camera
it sits right up in that little spot
there this is super nice you want a
manometer got especially when it comes
to uh to infants you want to be
controlling that amount of pressure
now you can see if i if i occlude this
here as i squeeze the bag
you're going to see a certain amount of
pressure right you see the little needle
flipping back and forth there
now
this right here is a pop-off valve this
is set to 40 centimeters of water of
pressure so if i occlude
this
you're gonna see that this thing pops
off and doesn't allow me to get up to 40
of pressure
you can even hear it
and so you may wonder like why would you
ever build a bar
to hold this down
well sometimes during neonatal
resuscitation you need higher pressure
maybe the baby was premature you have a
high
air surface tension because they don't
have surfactant and the p in the mr sopa
troubleshooting ventilation
acronym is pressure so you may need to
apply more pressure in order to see that
chest elevate we know that's our
ultimate goal we want to see that chest
rise
so you could either hold this down and
give a couple breaths or you could
actually put this up and then now i can
deliver higher than 40 centimeters of
water of pressure
now if we come over to
this side of the bag
this is the thing that i don't really
like i'm not too crazy about
corrugated tubing as my
reservoir bag i would much rather what
what we have on this lara doll bag this
is an
actual reservoir bag here
and the the point of this is this is
going to fill with
oxygen right this is what's coming off
of my oxygen tree it's going to fill up
and then i'm going to squeeze the bag
i'm going to deliver the breath and then
when i let go the bag is going to
inflate with the oxygen from this bag
now if you look at this one
as oxygen comes in here
as it's flowing in it's going to go into
this corrugated tubing
now this bag is only 180 ml with one
squeeze obviously you're not going to
squeeze the whole thing
um but the thing i don't really like
about this is the visual cue
so if i'm using this bag
i'm going to be watching for this to be
inflated and probably changing in volume
as i'm bagging
if i have this one i can't even tell
that the oxygen is on right it's not
really going to change anything and so
in the middle of a resuscitation if i
have some
auditory exclusion we know that like
that's normally one of the first things
to go is your hearing
when you're stressed out i'm not going
to hear that regulator maybe and then
it's really i'm not going to have the
visual cue either so i would much rather
have this off and then have the
reservoir bag on here instead
now the oxygen tubing
if you're looking for
something that
is beneficial with oxygen tubing find
one that has
pull this out
find one that has both it can go on the
christmas tree if you need it to
but it can also
screw right onto the actual oxygen
source
so those little christmas tree things
are single patient use now in some
hospitals i don't know i don't know if
that's the case in the ambulances but
somebody may have forgotten to put one
on and if you need oxygen right away
this is a nice little fail safe because
you can do either it's a really nice
design you can either go straight to the
oxygen source
or you can actually just uh put this
over the uh the christmas tree so this
is super beneficial
now when you are
pre-oxygenating you want to be really
really careful
my little manometer fell out
you want to be careful not to give too
much pressure and that's really where
this is going to come in handy
it's been said that the esophageal
sphincter
especially in kids it doesn't have a lot
of tone and it it can pop open when you
start getting up near
20-25 centimeters of water of pressure
so if you're ventilating a kid in the
pre-ox period
you want to make sure that you're not
really driving home these breasts
because you're going to pop open that
esophageal sphincter and then what
that's going to do is cause gastric
insufflation your risk of having an
aspiration event go up drastically
so as soon as i finished up the video on
the last two bpms i got this in the mail
from bound tree this is the kiraplex bbm
and i am convinced this is probably the
best bbm out there i'm going to show you
why this is this is really cool i'll
start with like my favorite feature
this is where the oxygen connects to the
bbm
you cannot pull this off
and so many times when you're bagging
and everybody's running around the
recess room or in the ambulance
this gets pulled off because you got a
tight area and you got to keep putting
it back on
you can't do that with this one this one
actually screws on if i want to take
this off i gotta actually like
undo it and screw it it's based off of
this little uh screw thing here
and so if i put it back on like that
you're not gonna be able to peel this
thing off so that is brilliant i love
that they have this this feature on here
this end also has the dual adapter to
where you could go on like a christmas
tree or you could actually screw this on
and like seeing this part with the screw
and then this part as well
i almost feel like it would be better to
take the christmas tree off just secure
it on one end
to the actual source and then it's
secured on this end to the bbm so
strong work hiroplex that is that's
brilliant and i'd like to see something
similar to this
for suction catheters because a lot of
times you're suctioning and the suction
tubing comes off of the catheter so this
same technology
why don't we do that to the ducanto
catheter or something to prevent that
from falling off
all right this also has the reservoir
bag so i can actually see visual
indication that i have oxygen flowing
into it and then
this pop-off valve is set to 25 so if
you remember the other two one was 40
one was 35
i think 25 is probably the best right
because that lower esophageal sphincter
is probably going to pop open around
that 20 to 25 mark and so you don't even
if you weren't paying attention to the
manometer which i haven't even started
on how much i love that this is built in
you would still
not give too much pressure that would
still pop open for you and then once you
have an advanced airway in if you needed
more pressure then you can just put this
little plunger thing inside here and it
does say on here now it says pressure
high so that way it's indicating that
hey this is this is uh now
the stop or the pop-off valve is closed
and then you have to go off of the
manometer but i like that it just starts
off at 25 that's a really nice feature
now the manometer you saw on the last
one the manometer kind of fell out um i
don't know if they always would do that
but this one definitely is not like this
one is this is sturdy this isn't going
anywhere it's built into the actual bbm
which super cool strong work with that
because now i don't have to worry about
attaching it or losing it or falling off
now the the peep attachment right here
is super cool
this has the ability to take either
these small diameter peep valves or if
you know maybe somebody didn't restock
the one that you needed and they're like
hey i have this peat valve you can
easily just put this one on as well so
it can take any size peep valve and you
can just attach it i would love to see
these just already attached and that
they don't come off but you can't get
this peep valve to go down to zero the
only way to get it down to zero is to
actually just just take it off the
entire bbm so i get that it's like a
safety concern thing so um this is the
peat valve that comes with it this is
nice i like it it's kind of a smaller
form factor but you know some clown
forgets to restock your bag and maybe
somebody else that you're on scene with
has one of these
these are nice you can just pop that
right on and get the same effect from it
so i love that the mask that comes with
this
if it is deflated from sitting in the
bag or if it's inflated too much um you
can adjust the the volume in here with a
syringe so that is uh super cool i like
that as well
so i'm gonna have a lot of fun with this
bad boy and uh and simulation and
i think that this is probably
the the best bbm built for resuscitation
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