PADI RTO First Aid Student Manual

Demand inhalator valve Oxygen masks with a demand inhalator valve act like a scuba regulator, delivering 100 percent oxygen to the casualty ‘on demand’ – only when the person takes a breath. Therefore, these devices are used on casualties who are breathing normally. By only providing an oxygen flow when the casualty inhales, the oxygen supply is conserved, allowing a given supply to last longer than when using constant-flow masks. Manually triggered resuscitator valves Many manually triggered resuscitator valves (MTRV) may also function as a demand inhalator valve. For non- breathing, injured casualties (e.g. scuba divers) they provide a fast, relatively simple and effective means to resuscitate them rather than using mouth-to-mouth or mouth-to-mask resuscitation which is more exhausting. On these units, a ventilation button is manually pushed by the rescuer to provide an injured, non-breathing casualty with a pressurised rescue breath of 100 percent oxygen. Bag-valve-mask A bag-valve-mask (BVM) consists of a facemask that covers the nose and mouth, and a large self-inflating bag with a series of one-way valves to provide positive pressure ventilations. Oxygen or air flows into the self-inflating bag, which may also have a reservoir bag like a non-rebreather mask. They can be attached to oxygen, thereby increasing the amount of oxygen provided with each positive pressure breath you provide to the casualty. The oxygen flow rate should be set to 15 LPM. With a reservoir bag, BVMs can provide 95-100% oxygen; without the reservoir bag, oxygen levels can drop to around 50%. Exhaled breath exits the mask via a one-way valve. BVMs are either disposable or can be cleaned and reused, therefore BVMs can be a cost- effective option to provide emergency oxygen. The masks are made of transparent material to allow detection of regurgitation. Bags for these systems come in three sizes - adult, paediatric and infant (paediatric and infant bags must include a ‘pop-off ’ pressure relief valve); adult bags should not be used on children as over-inflation of the lungs is likely to occur. After training, repeated practice is required to maintain the skill level. In Guideline 10.4 (Use of Oxygen in an Emergency), the ARC recommends that when bag- valve-mask oxygen resuscitation is used by trained but occasional operators, a minimum of two trained rescuers are required to provide ventilation for a non-breathing victim: one to manage the airway, mask and seal and the second to operate the bag. If you are the rescuer using the BVM, the best delivery method is to position yourself at the top of the casualty’s head so you can watch the chest rise and fall with each ventilation while you maintain an open airway and a proper seal; squeeze the resuscitation bag enough to see the casualty’s chest rise and fall, then release the bag. Slow, gentle ventilations minimise the risk of gastric inflation and regurgitation.

HLTAID007 - PROVIDE ADVANCED RESUSCITATION

HLTAID007 - PROVIDE ADVANCED RESUSCITATION

Considerations when providing supplementary oxygen In this section we will look at the benefits of providing suction during the application of advanced resuscitation techniques and of providing oxygen to a casualty. You’ll also be introduced to the selection and operation of oxygen masks and other appropriate devices as well as potential complications with the use of a bag-valve-mask device and suitable strategies to minimise these. What are the benefits of providing suction to a casualty? Use of a suction device in emergency situations helps to maintain oral hygiene and comfort for the casualty and the Emergency Responder as it removes copious secretions (e.g. vomit or blood) from the casualty’s mouth. What are the benefits of providing oxygen to a casualty? Many injuries, diseases and intoxications interfere with normal oxygenation of the blood or tissues and a lack of or reduction in oxygen in the bloodstream can become life-threatening. Providing oxygen helps to slow breathing rates, calms the casualty down and allows the body to beginning the recovery process more effectively. The short-term administration of supplemental emergency oxygen to a breathing casualty will not cause harm in most circumstances. In a non-breathing casualty, oxygen may be used if available and only if the appropriate equipment and trained personnel are available. What are different types of oxygen masks? Simple mask A simple mask (also known as Hudson mask) covers the nose and mouth and is held in place by a strap. Oxygen flows into the mask and is inhaled with each breath the casualty takes. Openings in the mask allow air to enter as well because oxygen flow alone does not provide enough volume for each breath. It delivers an oxygen concentration of up to 60% and can be connected to either a constant flow regulator (set to 15 litres per minute (LPM) for adults, or 4-6 LPM for children) or to a demand resuscitator or inhalator valve. Simple masks can be used on breathing and non-breathing casualties. Non-rebreather mask Non-rebreather masks are similar to simple masks but make much better use of oxygen. As their name implies, the casualty does not ‘rebreathe’ his exhaled breath – instead, it is dumped out of the mask through three non-return valves. Non-rebreather masks feature an attached reservoir bag that contains 100 percent oxygen and are the preferred masks used for providing oxygen to responsive and unresponsive breathing casualties. The flow rate should be set to 15 LPM. Resuscitation / Pocket mask Resuscitation or pocket masks are used to deliver higher concentrations of oxygen to non-breathing casualties when the mask has a supplemental oxygen inlet so it can also be used for oxygen resuscitation. As with the previous masks, the flow rate should be set to 15 LPM. With the addition of oxygen, these masks can deliver a concentration of over 40 percent (as opposed to the 17 percent with mouth-to-mouth rescue breathing only).

VII-7

VII-6

PADI RTO

PADI RTO