Ventilation Techniques

If a player is not ventilating adequately, then this must be supported. The most common devices in use in immediate care are the pocket face mask and the bag-valve-mask device. The pocket face mask allows the rescuer to blow exhaled air into the player’s lungs using a mouth to mask technique.

Key to this technique is the ability to create a good seal between the mask and the players face. This can be done by holding the thumb and forefingers in a C-shape down either side of the mask and then hooking the middle and ring fingers under the player’s angle of mandible. A different but equally effective technique is for the rescuer to place his thenar eminence and radial border of the thumbs along either side of the mask, and lift the mandible forward as described above. These techniques have the effect of lifting the players face up into the mask, while pushing the mask down onto the players face. The rescuer then blows into the mouthpiece of the mask, so that the player receives exhaled air.

This will supply the player with approximately 16% oxygen. The pocket face mask has a port for oxygen supplementation if oxygen is available.

Pocket mask ventilation with supplementary oxygen

The bag valve mask device has a mask which is very similar to the pocket face mask (in fact most pocket face masks are compatible with the BVM device). This should be applied to the players face as described above. Unless the rescuer does this on a frequent basis, it should be done with two hands to create an optimal seal, and a second rescuer should squeeze the bag.

These devices have the advantage of avoiding direct person to person contact as required with mouth to mouth, and therefore reduces the risk of cross infection, and makes it a more acceptable procedure for the rescuer.

Common errors with the use of BVM’s are forgetting to connect to oxygen, squeezing the bag too fast and too hard. Ideally a ventilation should be delivered every 5-6 seconds.

Using these devices, are likely to cause gastric inflation and therefore if continued for any length of time, there is a significant risk of the patient vomiting and aspirating.

Bag valve mask ventilation