Pediatric emergency medicine trisk 0203 0203

Simple masks. The simple face mask delivers a moderate FiO2 that varies from
35% to 60%.
Partial rebreathing masks. Partial rebreathing masks allow reliable delivery of an
FiO2 of 50% to 60%. When the flow in the reservoir bag is greater than the
patient’s minute ventilation and the oxygen is adjusted so the bag does not
collapse during inhalation, there is negligible CO2 rebreathing allowing for more
reliable oxygen delivery.
Nonrebreathing masks. These masks have nonrebreathing valves incorporated
into the face mask and the reservoir bag and reliably provide oxygen
concentrations up to 95% with high flow rates of 10 to 15 L/min.
Continuous Positive Airway Pressure Devices
CPAP provides positive pressure to stent open the child’s airways leading to
improved ventilation and oxygenation. CPAP can be applied with large nasal
prongs, a nasal mask which covers just the nose of the patient, or a face mask
which covers the mouth and nose.

Assisted Ventilation
Basic Life Support (BLS) rescue breathing rate in infants and children with
isolated respiratory arrest is 12 to 20 breaths/min, with higher rates for infants and
younger children. Newly born infants may need a rate of 40 to 60 breaths/min.
For children and infants who require CPR, the recommended respiratory rate is 8
to 10 breaths/min. Ventilations are asynchronous with chest compressions when
an advanced airway is in place. When an advanced airway is not in place,
ventilations are coordinated with chest compressions with a rate of 15
compressions to 2 ventilations for two providers and 30 compressions to 2
ventilations for one provider (100 to 120 compressions/min). With all ventilation
techniques, the force and volume needed to just see chest rise is recommended.
Overventilation is a common error in resuscitation; the AHA 2015 Update
emphasizes a ventilation rate of less than 12 and a ventilation volume that causes
no more than minimal chest wall rise during CPR.
Because of risk of infection transmission, mouth-to-mouth resuscitation is no

longer recommended. Instead, rescue breathing is done with a pocket mask.
Placement of the mask over the mouth alone, over the mouth and nose, or over a
tracheostomy site depends on the patient and the equipment available.

Expired Air Techniques