Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
Equipment for Ventilation
• Bag and mask: a newborn resuscitator bag (240-500 mL) with appropriate size face
masks (#1 for normal size newborn babies, #0 for LBW babies). (See Figure 8.3.) In
general, where resources are limited, the 500 mL bag is preferable as it can be used for
the normal weight baby and for the larger low birth weight infants which constitute the
biggest proportion of the high-risk group. Notes:
Figure 8.3. Self-inflating bag and mask for ventilation of babies.
o The resuscitator bag should be the self-inflating kind that inflates automatically after
it is squeezed and released. Bags that require a flow of air/oxygen mixes to inflate
are, in general, not appropriate for resuscitation.
o In certain models the mask consists of one piece of silicone/siliconized rubber; in
others, it consists of two parts, a plastic component to which a different transparent
soft plastic/rubber/silicone piece is attached. Make sure that the pieces are
appropriately attached so that the soft part is the one that comes in contact with the
baby’s face and not the hard plastic part that can hurt the baby.
o Check that the mask fits properly with the bag.
o To check the functioning of the self-inflating bag, block the mask by making a seal
with the palm of the hand.
o Then squeeze the bag. Make sure that you feel pressure against your hand that
indicates that the seal is working well without leaks. When the pressure is raised, it
can also force the pressure-release valve open. When the pressure is released, the
balloon should reinflate.
o Squeeze the bag only to the extent necessary to expand the chest. Excessive
pressure carries a risk of injury to the lungs.
• A supplemental oxygen source, if available. If cylinders are used, check that they have
adequate oxygen. Note that while it is good to have supplemental oxygen available, it is
not required in most cases.
• A wall clock with a second hand. In dealing with emergency situations such as asphyxia,
it is easy to lose track of time. It is important to note the time of birth and the time spent
in resuscitation, since there is a time limit to active resuscitation. The clock can also be
used to check the heart and respiratory rate in the delivery room.
Integrated maternal and newborn care
Basic skills course
97