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

[dawngloves, BSN, RN]

Any ICU I've worked in, adult or neonatal, has had a bag/mask and suction at the bedside.

[Love_2_Learn]

Thank you dawngloves for answering my post. Can you feel my big sigh of relief as I read your answer? :-) This is the same for my experience up until now as it appears saving money may be on management's mind too much these days.

Please clarify for me, the bag/mask and suction at the bedside is hooked up and connected to oxygen and suction sources and checked each shift to be sure it is all in working order, correct? (As opposed to unopened equipment from the manufacturer which is not put together, but just sitting at the bedside waiting to be put together...) Thanks again in advance!!

[NeoNurseTX, RN]

It should be checked to be READY TO USE hooked up to O2 with proper flow...same with suction. Sometimes I'll come in and there is not a proper fitting mask so I'll get one because the last thing you want to do is not have a mask (like if the kid was recently extubated) when you need to bag.

[umcRN, BSN, RN]

Bag/mask/suction set up & ready to use in our nicu/picu. Checked @ the start of every shift

[NicuGal, MSN, RN]

Bag/mask/sx at bedside. Bag and mask put together in a bag hooked up to O2 if not intubated, mask taped to bed and bag hooked to O2 with a cap on it at the bedside. We have separate suction for oral and ETT. Also our bags have built in manometers so we don't have to worry about finding one.

Oh and bags are replaced when visibly soiled.

[Preemie2RN]

In our unit, each baby has bag/mask set, connected and O2 flow on, checked and cleaned each shift and replaced if/when needed. Too risky not to have it there and ready to use when you consider how tiny our patients are and the amount of time (too little time) it takes to potentially harm them! Cleanliness is of course important , but wouldnt you rather treat a respiratory infection from a dirty mask/bag combo than to explain to the parents that their child has damage from hypoxia because we couldn't get the mask opened and set up fast enough???

.... p.s. yes I often wonder about all the extra free O2 in the air, and it could probably at least be turned down (I have recently posed that question to our docs-no answer yet)

[Preemie2RN]

oh and properly working and setup suction for each!

[rockabye]

Yep, everything is set up and ready to use at every patients bedside and checked at the start of each shift. We also keep the mask and bag in a plastic bag for cleanliness. The only time we replace these are if another mask size is needed or the equipment gets dirty or broken. The suction canister and tubing is replaced q week or as needed.

[nicu1991]

Yes, bag & mask completely set up attached to O2 supply in plastic bag, functioning and checked at beginning of every shift. Has built-in manometer. Suction set up & on with either a NeoSucker or Sx catheter attached inside a clean empty syringe holder with sx tubing kinked into syringe holder to stop noise. Bulb syringe depending on if intubated or crib. Have seen new bag & mask set ups in plastic bags hanging & when go to set one up for a planned admission, find parts missing or not functioning. How would they save money then? In our case, we have time to get another bag.

You are not mistaken in your belief. Stick to it. Sounds like a disaster waiting to happen, Hopefully someone will listen. Breathing is not optional, which I know you know that

[dawngloves, BSN, RN]

Please clarify for me, the bag/mask and suction at the bedside is hooked up and connected to oxygen and suction sources and checked each shift to be sure it is all in working order, correct? (As opposed to unopened equipment from the manufacturer which is not put together, but just sitting at the bedside waiting to be put together...) Thanks again in advance!!

Oh yeah. One of the first things I do at start of shift.

[Love_2_Learn]

Thank you all so very, very much for your replies to my question!! I continue to speak up and voice my point to everyone at work who will listen. I believe NRP guidelines say to have resuscitation equipment ready and I don't believe they mean simply when a delivery is expected.... anytime a resuscitation is needed we are to follow NRP guidelines.

I thought it was interesting that yesterday, after I posted my question, that I returned to work to find out that a 3 week old baby who is now 31 weeks and being fed by og tube had a spit up silently in his isolette about an hour after being fed; when the nurse saw his sat drop she checked on him. Long story short, a bulb syringe did not fix him, he ended up needing wall suction to clean his nares and actually was bagged by our nurse practitioner who was called to the bedside. They had an exciting time of it to say the least. He is fine now and x-ray shows no evidence of aspiration. Dare I mention that I had cared for the baby the night before and had left him with his bag/mask/suction all set up and in working order ready for emergency use. I think this episode opened some eyes, at least I hope it did. If nothing else, it confirms to me my insistence that when I am caring for a baby I will have my emergency equipment ready as NRP says... they can reprimand me if they feel the need but when those babies are in my care I will treat them with the same standard of care that the rest of the USA follows.

Thanks again to all of you for your responses. It means so much to me. Kudos to you all!:redbeathe:redbeathe