First Responder EMS Curriculum for Training Centers in Eurasia

minimum flow rate. The larger adult manual resuscitators require > 15 L/min of oxygen flow toreliably deliver high oxygen concentrations.Technique. To provide bag-mask ventilation, select a bag and mask of appropriate size. Themask must be able to completely cover the victim's mouth and nose without covering the eyes oroverlapping the chin. Once the bag and mask are selected and connected to an oxygen supply,open the victim's airway and seal the mask to the face.If no signs of trauma are present, tilt the victim's head back to help open the airway. If trauma issuspected, do not move the head. To open the airway of the victim with trauma, lift the jaw,Figure 30. Bag-mask ventilation for childvictim. A, 1 rescuer; B, 2 rescuers.using the last 3 fingers (fingers 3, 4, and 5) of one hand. Position these 3 fingers under the angleof the mandible to lift the jaw up and forward. Do not put pressure on the soft tissues under thejaw, because this may compress the airway. When lifting the jaw, you also lift the tongue off theposterior pharynx, preventing the tongue from obstructing the pharynx. Place your thumb andforefinger in a "C" shape over the mask and exert downward pressure on the mask. This handposition uses the thumb and forefinger to squeeze the mask onto the face while the remainingfingers of the same hand lift the jaw, pulling the face toward the mask. This should create a tightseal between the mask and the victim's face. This technique of opening the airway and sealing themask to the face is called the "E-C clamp" technique. Fingers 3, 4, and 5 form an E positionedunder the jaw to provide a chin lift; the thumb and index finger form a C and hold the mask onthe child's face. Once you successfully apply the mask with one hand, compress the ventilationbag with the other hand until the chest visibly rises.Superior bag-mask ventilation can be achieved with 2 rescuers, and 2 rescuers may be requiredwhen the victim has significant airway obstruction or poor lung compliance. One rescuer usesboth hands to open the airway and maintain a tight mask-to-face seal while the other rescuercompresses the ventilation bag (see "Part 3: Adult BLS," 2-rescuer technique for bag-maskventilation). Both rescuers should observe the chest to ensure that it rises visibly with eachbreath.First Responder EMS Curriculum/AIHA, July 2002 357