Bedside PPV Bag & Masks

[Love_2_Learn]

I have a question about your babies and their bedside positive pressure ventilation bag & mask. Do the babies in your unit each have their own bag & mask at the bedside for emergency use? If so, do you have it hooked up to oxygen and check it each shift to be sure it is working properly (bag inflates properly, manometer working, oxygen flowing, correct flowmeter on oxygen port, etc.) Also, how often do you replace the bag & mask? I agree with keeping them covered in a plastic bag at the bedside to keep them clean.

I may be old school but I was taught that in the intensive care unit (NICU and step down) that each baby should have their own emergency equipment at the bedside and it should be checked each shift to be sure it is in working order in case an emergency occurs. When I say emergency equipment I'm talking about a PPV bag & mask with manometer, oxygen source, and suction canister with tubing set at the appropriate mmHg as well as a bulb syringe.

Just wondering if I am off base here and if other hospitals are doing things differently these days. (I can understand not using a bulb syringe for intubated babies as part of a VAP bundle though but feel one should be nearby in case you need it if your suction catheter or other suction device gets contaminated and you need to suction a baby's mouth or nose in an emergency.) I just don't think it's safe to have the bag & mask & manometer in an unopened bag (exactly as it comes from the manufacturer) at the bedside which would have to be put together while I pray the bag/mask as well as the oxygen flowmeter & source are working correctly if an emergency occurs. It could take a good minute to get it all put together even if it all went well while the baby is blue and floppy and needing assistance. I'd hate to be on a witness stand trying to explain why emergency equipment was not at the bedside in working order when an emergency occurred.... Am I being overly cautious or overly prepared -versus- fiscally responsible and trying to save money?

Thanks in advance for any insight you can share!! :redbeathe

[NicuGal, MSN, RN]

We dont' leave the O2 on...it only takes a second to turn it on...and you should have checked it at the beginning of the shift to make sure the bag was okay. We also don't leave our suction on unless it is hooked to an inline suction.

[nicu1991]

Love2Learn, it was that pts fortunate experience that you had everything ready! My fear was that they were going to have to learn by having a situation like that without anything set up. That usually will make changes all around depending who is involved, right? I'm glad it did not get to that point. You are a true pt advocate and show safety is a priority. Good job Love2Learn!!!!

[kalamazoo]

our unit has a bag and mask for each patient, out of the bag and checked each shift that it is functioning and that the proper setting is on the flow control valve. The oxygen is connected but not turned on. They have their own suction and it is also checked each shift and is to be left turned on. As part of the vap bundle intubated babies cannot have a bulb syringe in the bed but there is one in a cart next to the bed for emergencies. The bag and mask is only changed as needed. The suction tubing is labeled and changed every 24hrs by the night shift and the cannister every 7 days by the night shift. The "neosucker" for oral suctioning is kept in an unsealed ziplock baggie at the head of the bed and is changed out every day shift and labeled. Our VAP numbers are extremely low and lower than vermont oxford averages. We must do oral care prior to any suctioning and do not routinely use saline in the ETTube.

[walkingrock, ADN]

:thankya: We have 'em set up, checked, functioning for each pt... The only change of practice I see, is they don't want admit beds set up in advance...open and set up when the baby is on the way, same with L & D...they don't want the warmers set up with equipment opened until a baby is a-birthin' in the next few minutes.