Infant Bag Valve Mask (BVM) - Which One Is The Best?

Summary

The 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

00:00

👶 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.

05:01

🌬️ 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.

10:02

🛠️ 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.

Keywords

💡BBM

BBM stands for 'Bag-Valve-Mask,' which is a manual device used to provide positive pressure ventilation in situations where a patient is unable to breathe adequately. In the video, the BBM is the central theme, with different types being compared and evaluated based on their suitability for resuscitation.

💡Mercury Medical Infant VVM

This refers to a specific brand and model of BBM designed for infants, featuring a visual indicator (VVM) to monitor ventilation. The script mentions this model as one of the options being compared, noting its lack of certain features like a peep valve and manometer, which are important for resuscitation.

💡Resuscitation

Resuscitation is the process of reviving someone who has stopped breathing or whose heart has stopped. In the context of the video, the suitability of different BBMs for resuscitation is a key point of discussion, with features that facilitate this process being highlighted.

💡PEEP Valve

A PEEP (Positive End-Expiratory Pressure) valve is a component that helps maintain positive pressure in the lungs to keep them inflated. The video discusses the importance of having a PEEP valve for certain BBMs, especially for resuscitation, and how some models come with this feature built-in.

💡Manometer

A manometer is a device used to measure pressure, and in the context of a BBM, it helps to monitor the pressure being delivered to the patient's lungs. The script mentions the manometer as an essential feature for controlling ventilation pressure, especially in infants.

💡Pop-Off Valve

A pop-off valve is a safety mechanism that releases pressure once a certain threshold is reached. In the video, the pop-off valve settings of different BBMs are compared, with the importance of having a valve set to an appropriate pressure level for patient safety discussed.

💡Corrugated Tubing

Corrugated tubing is a type of flexible hose that can be used in medical equipment. The video script describes a preference for a reservoir bag over corrugated tubing as a visual cue for oxygen flow in a BBM, indicating a potential issue with visibility and reliability in high-stress situations.

💡Oxygen Reservoir Bag

An oxygen reservoir bag is a component of a BBM that collects and stores oxygen, allowing for the delivery of oxygen-rich breaths. The video emphasizes the importance of having a visible reservoir bag for clear indication of oxygen flow and the ability to manually adjust the volume of oxygen delivered.

💡Kiraplex BBM

Kiraplex BBM is a specific model of BBM mentioned in the script as potentially the best for resuscitation. It is highlighted for its features such as a secure oxygen connection, a built-in manometer, and a pop-off valve set at a safer pressure level for infants.

💡Pre-oxygenation

Pre-oxygenation is the process of administering oxygen before intubation or other procedures that may temporarily interrupt breathing. The script discusses the importance of careful ventilation during pre-oxygenation to avoid complications like gastric insufflation and aspiration.

💡Esophageal Sphincter

The esophageal sphincter is a muscle that helps keep the stomach contents from entering the esophagus. The video mentions the risk of this sphincter opening under high pressure, which can lead to gastric insufflation and increased risk of aspiration during ventilation.

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