Functions and Operating Procedures of Manual Resuscitators

Manual resuscitator—also known as a simple resuscitator or bag-valve-mask—is a portable, manually operated emergency device for artificial ventilation. It consists of an elastic bag, a face mask, a one-way valve, a reservoir bag, and an oxygen inlet. Requiring no power source, it can be operated by hand to provide assisted breathing to patients suffering from hypoxia or respiratory arrest.

 

 

1. Emergency artificial ventilation: Rapidly delivers oxygen to maintain pulmonary ventilation in cases of weak breathing or respiratory arrest.
2. Correction of hypoxia: Rapidly increases blood oxygen saturation to prevent cerebral hypoxia and organ failure.
3. Pre-hospital emergency care: Provides on-site emergency resuscitation for incidents such as traffic accidents, drowning, suffocation, fainting, and cardiac arrest.
4. Intrahospital transitional ventilation: temporary respiratory support during intervals in resuscitation or before and after intubation.
5. Postoperative recovery: respiratory support for patients who have not yet regained consciousness after anesthesia.
6. Emergency backup: temporary alternative ventilation in the event of ventilator failure.

 

 

Patients experiencing respiratory arrest, asphyxia, shock, or coma; patients recovering from general anesthesia; and patients with critical respiratory failure.

 

 

1. Assess the environment: Confirm scene safety; tap and call out to the patient; determine unresponsiveness and absence of spontaneous breathing.
2. Open the airway: Clear foreign objects from the mouth and nose; open the airway using the head-tilt, chin-lift maneuver.
3. Position the patient: Place the patient in a supine position with the head tilted back.
4. Apply the mask: Fit the mask tightly over the patient's mouth and nose; secure the mask with one hand (using the E-C clamp technique).
5. Squeeze the bag: Use the other hand to rhythmically squeeze the resuscitation bag
- Adults: 10–12 breaths/minute; deliver approximately 500–600 ml per breath
- Children: 12–20 breaths/minute
6. Observe ventilation: Chest rise and fall indicates effective ventilation.

7. Continue resuscitation: Until spontaneous breathing resumes or professional emergency personnel take over.

 

 

1. Contraindications and Precautions Regarding Patient Condition
- Use with caution in cases of severe maxillofacial trauma, facial fractures, massive hematemesis, or untreated pneumothorax.
- For unconscious patients with a full stomach, take measures to prevent gastric distension and aspiration resulting from vomiting.

 

2. Operational Guidelines
- Ensure a tight seal between the mask and the face; air leaks will render ventilation ineffective.
- Do not squeeze the bag with excessive force to avoid barotrauma and gastric distension.
- Deliver air slowly, with an inflation duration of approximately 1 second.
- If an oxygen source is available, connect it; an oxygen flow rate of 8–10 L/min yields the best results.

 

3. Resuscitation Coordination
- Single-rescuer: 30 chest compressions + 2 bag-valve-mask ventilations.
- Two-rescuer: Coordinate compressions and ventilations smoothly to avoid interference.

 

4. Disinfection and Storage
- Single-use components are for one-time use only; reusable components are for dedicated individual use.
- After use, disassemble, clean, disinfect, and air-dry; store in a dry place away from direct light.
- Periodically inspect the bag and valves for air leaks or signs of aging.

 

5. Common Errors
- Ventilating without opening the airway.
- Mask air leakage; compression rate too fast.
- Over-ventilation causing patient discomfort.