Advanced Trauma Life Support ATLS Student Course Manual 2018

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APPENDIX G n Skills
One-Person Bag-mAsk
Ventilation
STEP 1. Select the proper size of mask to fit the
patient’s face. The mask should extend from
the proximal half of the nose to the chin.
STEP 2. Connect the oxygen tubing to the bag-mask
device and adjust the flow of oxygen to
15 L/min.
STEP 3. Ensure that the patient’s airway is patent
(an oropharyngeal airway will prevent
obstruction from the tongue).
STEP 4. Apply the mask over the patient’s nose and
mouth with the dominant hand, ensuring a
good seal. This is done by creating a ‘C’ with
the thumb and index finger while lifting the
mandible into the mask with other three
fingers of the dominant hand.
STEP 5. Initiate ventilation by squeezing the bag with
the non-dominant hand.
STEP 6. Assess the adequacy of ventilation by
observing the patient’s chest movement.
STEP 7. Ventilate the patient in this manner every
5 seconds.
two-Person Bag-mAsk
Ventilation
STEP 1. Select the proper size of mask to fit the
patient’s face.
STEP 2. Connect the oxygen tubing to the bag-mask
device and adjust the flow of oxygen to
15 L/min.
STEP 3. Ensure that the patient’s airway is patent
(an oropharyngeal airway will prevent
obstruction from the tongue).
STEP 4. The first person applies the mask to the
patient’s face, performing a jaw-thrust
maneuver. Using the thenar eminence (or
thumbs-down) technique may be easier for
novice providers. Ensure a tight seal with
both hands.
STEP 5. The second person initiates ventilation by
squeezing the bag with both hands.
STEP 6. Assess the adequacy of ventilation by observing
the patient’s chest movement.
STEP 7. Ventilate the patient in this manner every
5 seconds.
Part 2: Advanced Airway Management
Skills Included in this
Skill Station
••
Insertion of Laryngeal Mask Airway (LMA)
••
Insertion of Laryngeal Tube Airway (LTA)
••
Oral Endotracheal Intubation
Insertion of Laryngeal
mAsk Airway (LMA)
STEP 1. Ensure that adequate ventilation and
oxygenation are in progress and that
suctioning equipment is immediately
available in case the patient vomits.
STEP 2. Choose the correct size of LMA: 3 for a small
female, 4 for a large female or small male,
and 5 for a large male.
STEP 3. Inspect the LMA to ensure it is sterile and has no
visible damage; check that the lumen is clear.
STEP 4. Inflate the cuff of the LMA to check that it
does not leak.
STEP 5. Completely deflate the LMA cuff by pressing
it firmly onto a flat surface. Lubricate it.
STEP 6. Have an assistant restrict motion of the
patient’s cervical spine.
STEP 7. Hold the LMA with the dominant hand, as
you would hold a pen, placing the index
finger at the junction of the cuff and the
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