Ambu bag with COPD patient question..

dudette10, MSN, RN · May 18, 2015

Or so i thought so until today.

Explain please?

spacemonkey15 · May 18, 2015

I know this is old,but a nursing coworker said that an Ambubag (BVM) can be used without O2......
I have never heard of that before,but i guess is it possible?

You could hand ventilate someone using an air flow meter, but why would you want to bag someone who is arresting (UK speak for coding) and is probably profoundly hypoxic anyway? Even if they are a COPDer with risk of losing their respiratory drive if you're having to manually ventilate them they've already lost the ability to ventilate themselves. Hypoxia will kill them quicker than hypercarbia. Chances are they'll end up tubed and ventilated (leading to a lengthy intubation probably as they're a nightmare to wean).

I suppose you could bag someone who has lost their drive through too much O2 on air in the hope of getting them to spontaneously ventilate again, however I've never heard of it happening, it's a decision I'd rather leave to an experienced anaesthetist.

FlyingScot, RN · May 18, 2015

You could hand ventilate someone using an air flow meter

Why would you do this? An ambu-bag is self-inflating. It doesn't need any type of flow to work. That being said...yes, a coding patient should be ventilated with O2 unless it is a known pediatric cardiac patient for whom oxygen is contraindicated.

spacemonkey15 · May 18, 2015

Why would you do this? An ambu-bag is self-inflating. It doesn't need any type of flow to work. That being said...yes, a coding patient should be ventilated with O2 unless it is a known pediatric cardiac patient for whom oxygen is contraindicated.

Yeah, of course. Sorry wasn't thinking when I posted and was visualising Mapelson C circuits that we tend to use over ambu bags.

JustBeachyNurse, LPN · May 18, 2015

I know this is old,but a nursing coworker said that an Ambubag (BVM) can be used without O2......
I have never heard of that before,but i guess is it possible?

This would be if you had an arrest but no O2 such as in a supermarket. If O2 is available USE IT

BVM sans O2 beats mouth to mouth. Effective, proper compressions without ventilation until ALS & EMS arrives will sustain a patient until BVM plus O2, intubation and ACLS protocol can be initiated.

Unless a pedi or neonatal patient has a medical condition when excess O2 is contraindicated, oxygen is essential to bring the dead back to life along with effective compressions

VANurse2010 · May 18, 2015

Was reading some threads on ambu bags and came up with a scenario. If a pt. has copd and is a code how many liters of o2 do we give while using the ambubag connected to oxygen. standard is about 10-15liters with no copd, but wat if the pt. has COPD?

If the patient is hypoxic enough to need bagging, I suggest you jam up that O2.

FlyingScot, RN · May 18, 2015

Yeah, of course. Sorry wasn't thinking when I posted and was visualising Mapelson C circuits that we tend to use over ambu bags.

That's what I thought! :wacky:

vanilla bean · May 18, 2015

If a patient is arresting/coding - use O2 (if available). As PPs have mentioned, self-inflating AMBU bags do not require flow from an outside gas source to be functional and bagging with room air is better than nothing if O2 is not available.

That said, over my years working as an RT, there have been numerous occasions in which I have intentionally bagged a COPD patient using room air or minimal O2, but these were not "code" situations - usually it was a situation where we knew or suspected that our patient was hypercapneic and was obtunded or had an altered LOC.

JustBeachyNurse, LPN · May 18, 2015

Nothing like rejuvenating a 4 year old thread with current practice information!

smartnurse1982 · May 18, 2015

This would be if you had an arrest but no O2 such as in a supermarket. If O2 is available USE IT
BVM sans O2 beats mouth to mouth. Effective, proper compressions without ventilation until ALS & EMS arrives will sustain a patient until BVM plus O2, intubation and ACLS protocol can be initiated.
Unless a pedi or neonatal patient has a medical condition when excess O2 is contraindicated, oxygen is essential to bring the dead back to life along with effective compressions

I thought it was best to use 02 also,whether or not the patient needs it.

What brought the subject up is that we had a nurse use the BMV with 2L of 02 from the concentrator,and not the tank even though tank was right next to the O2 concentrator.

She should have used 10 to 15 liters(8 yr old peds)

Boggles the mind..

FlyingScot, RN · May 18, 2015

I thought it was best to use 02 also,whether or not the patient needs it.
What brought the subject up is that we had a nurse use the BMV with 2L of 02 from the concentrator,and not the tank even though tank was right next to the O2 concentrator.
She should have used 10 to 15 liters(8 yr old peds)
Boggles the mind..

Well that wasn't too bright. ðŸ˜³

JustBeachyNurse, LPN · May 18, 2015

I thought it was best to use 02 also,whether or not the patient needs it.
What brought the subject up is that we had a nurse use the BMV with 2L of 02 from the concentrator,and not the tank even though tank was right next to the O2 concentrator.
She should have used 10 to 15 liters(8 yr old peds)
Boggles the mind..

Can't fix those that refuse to follow BLS protocol. Can't imagine that works with your company SOP.

Unless it was a cardiac/pulmonary child with one of the conditions where high O2 is contraindicated.

Even a pulmonary kiddo with asthma or BPD that goes into respiratory arrest needs as close 100% O2 which is minimum 10LPM