![]() Institutional Review Board approval was given for this study. 3 We assessed adult and pediatric BVM ventilation in a simulated scenario, comparing the mean tidal volume, peak pressure, and respiratory rate for each. 7, 8, 9 The volume of pediatric BVMs can range anywhere between 500–1000 mL with stroke volumes of 450–650 mL, 7, 8, 9 closer to the targeted tidal volume for adult patients who are critically ill or in cardiac arrest. 3, 4, 5, 6 The reservoirs of adult BVMs contain between 1500–2000 mL of air, depending on manufacturer and model, with projected stroke volumes of between 900–1000 mL. To achieve lung-protective ventilation for intubated patients, the average tidal volume should be between 5–8 milliliters per kilogram (mL/kg) of ideal body weight. Stroke volumes of BVMs are defined by the manufacturer as the projected delivered tidal volume by manually squeezing the bag. 2 The purpose of the study is to determine whether healthcare providers are unintentionally delivering pressures and volumes that could potentiate injury during manual ventilation using BVMs. Conditions such as interstitial emphysema, pneumothorax, pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum are clinical presentations of barotrauma. 1 Positive pressure ventilation provided via bag valve masks (BVMs) may expose patients to high airway pressures and volumes, potentiating similar alveolar damage. Barotrauma is defined as trauma caused by rapid or extreme changes in pressure affecting enclosed cavities within the body. Volutrauma describes structural lung injury due to over-distention of the alveoli that occurs when higher than physiologic volumes are delivered. Barotrauma refers to damage sustained to the lung from rapid or excessive increases in pressure. High volumes delivered during positive pressure ventilation can precipitate lung injury in a patient already suffering from an underlying pulmonary pathology.
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