Lecture Notes: When to Use a Bag Valve Mask (BVM) in EMS

Introduction

• Purpose: To explain when to use a BVM effectively in emergency medical services.
• Audience: EMTs, paramedics, and students preparing for exams like NREMT.

Key Points on BVM Usage

• Function of BVM:

  • Aids in ventilating patients who cannot ventilate themselves.
  • Ensures carbon dioxide is expelled and oxygen is inhaled.

• When to Use a BVM:

  • Airway Control Issues: Patients unable to control their airway; requires airway adjuncts like OPA or NPA.
  • Abnormal Respiratory Rates:
    • Too Low: Respiratory rate lower than the normal adult range of 12-20 (e.g., rate of 8).
    • Too High: Unresponsive with an abnormally high respiratory rate.
  • Weak/Sluggish Respirations: Patients at risk of losing the ability to breathe (semi-responsive or slipping into unresponsiveness).

Equipment Overview

• NPA (Nasal Airway Adjunct): Inserted through the nostril to maintain airway.
• OPA (Oral Airway Adjunct): Inserted through the mouth to maintain airway.
• BVM (Bag Valve Mask): Used for ventilation, connects to high-flow oxygen in an ambulance.

Patient Scenarios

• Patient 1:
  • 80-year-old male, shortness of breath, respiratory rate of 18, SpO2 at 93%.
  • Treatment: Start with a nasal cannula, possibly upgrading to a non-rebreather mask.
• Patient 2:
  • 80-year-old male, unresponsive, respiration rate of 6, SpO2 at 86%.
  • Treatment: Utilize BVM due to airway and ventilation issues.

Mnemonic for BLS Airway Management

• Steps (Open, Clear, Keep, Ventilate):
  1. Open the airway: Head tilt-chin lift (medical) or jaw thrust (trauma).
  2. Clear the airway: Remove obstructions or perform suctioning.
  3. Keep the airway open: Use OPA/NPA for patency.
  4. Ventilate with a BVM: Attach to high-flow oxygen (~15 liters).

Additional Resources

• Paramedic Coach Program: Offers 180+ video courses covering EMS medicine, designed to prepare for school and national exams.
• Testimonials: Confirms program effectiveness and student success in passing exams.

Conclusion

• Goal: Decrease failure rates in EMT and paramedic exams by providing comprehensive resources and training.
• Engagement: Encourages participation in discussions and course offerings for enhanced learning.