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Oxygen Supplementation Part 2

Avir Mitra, MD and Neda Frayha, MD
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22:34
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We provide supplemental oxygen all the time. But how often do we really understand the physiology behind what we’re doing, or the different modalities we have available to us? Dr. Avir Mitra, Clerkship Director of Emergency Medicine at the Icahn School of Medicine at Mount Sinai Beth Israel in New York, joins Neda for a conversation about O2 supplementation, mechanical airway support, and the tools we have to oxygenate and ventilate our patients. 

 

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Ian L., Dr -

This bag valve variable is the degree of squeeze -is there a way of knowing how many ml of oxygen you are squeezing in and how fast .

Neda F., MD -

Hi Ian. Here's Dr. Mitra's response: "Good question! Most BVM bags carry a total of 1,500cc of air (1.5L). If you estimate an average tidal volume of, say 500c, then you would want to squeeze no more than 1/3 of the bag. To the best of my knowledge, there is no way to accurately tell how many cc of air you are pushing in and the exact degree of pressure you are creating. Anesthesiologists that I have worked emphasize a "feel" for the bag and using chest rise on the patient as a way of gauging your tidal volumes and pressures. Depending on the size of your hand, you should be doing no more than one hand-full of a squeeze of the bag, and if your hand is bigger it should be a partial squeeze. Another tip is to squeeze the bag in time with your own breaths - this helps you estimate a good rate and flow. "

Ian L., Dr -

Fascinating young bioengineering students at Rice University in America have designed a machine that compressed an ambush mechanically with settings to feed the right amount of air to adults children and infants .
It is a rack and pinion device made of plastic parts from 3D printing .and is designed to help with ventilation in low resource countries .
It is called “Take a Breather “
It is on y tube and google .

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Hippo Primary Care RAP Written Summary February 2020 764 KB - PDF

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