Lifesavers trained in the delivery of oxygen (ART holder) can supervise team members in the delivery of oxygen via a bag-valve-mask (BVM) once it is connected and working. The ART holder brings oxygen into the scenario in the 10 o’clock position (patient’s right shoulder). Oxygen does not need to be turned off or moved away during shock delivery, only directing oxygen flow away from the patient during shock delivery.
Specifics of oropharyngeal (OP) airway insertion and BVM preparation are detailed in the ART award.
Once the ART holder has attached the BVM to the oxygen supply, they provide the first 2 breaths within the CPR cycle to ensure adequate seal and chest rise. Following this, they move to the Team Leader role at the patient’s feet.
The BVM is best operated by 2 rescuers (Operator 2 on the resuscitation mask and either Operator 1 or 3 squeezing the bag).
- Operators 1 and 3 alternate compressions every 2 minutes, and while not undertaking compressions, deliver breaths using the BVM. Additional rescuers can take over the positions of Operators 1 and 3, without interrupting CPR, during AED analysis
- Operator 2 continues to provide jaw thrust, holding the resuscitation mask in place, only pausing when undertaking the AED analysis / shock delivery role every 2 minutes, detailed above
- Deliver two breaths, allowing 1 second for each, as per ANZCOR guidelines
- Avoid over-ventilation, aim for minimal chest rise (enough to see a slight rise only).
Rule of 3s for BVM use
- Use one hand – hold with 3 fingers and the thumb (can use other hand to support, such as the right hand in the diagram)
- Squeeze a maximum of 1/3 of the bag volume
Training is key. Use of feedback manikins allows rescuers to practice correct technique for jaw thrust with resuscitation masks and squeezing the BVM.