Processing the ambu bag after using the algorithm. Algorithm and technique for performing IVL using an ambu bag

Respiratory arrest is one of the critical conditions requiring emergency medical attention or the intervention of unskilled medical personnel. In such a situation, there is not always access to resuscitation equipment and the ability to use a full-fledged ventilator. The Ambu bag is a simple device with which you can carry out this procedure.

Design features

The basis of the bag for artificial lung ventilation is a rubber elastic pear, which has an inlet valve on one side, and is equipped with a special adapter on the other. The Ambu bag can be connected to a mask using this adapter, or it can be directly connected to an endotracheal tube fixed in the trachea. The method of application will depend on the characteristics of the particular situation requiring medical attention.

This device has firmly won its application in the field of critical care medicine, in ambulances and intensive care units. By varying the volume of the rubber bulb, you can use the Ambu bag in pediatric practice.

Usage algorithm

Before using the Ambu bag, you must make sure that the upper respiratory tract is open and that there are no foreign objects in the oral cavity. To do this, lay the patient on his back, tilt his head back and open his mouth by moving the lower jaw slightly towards himself and down. In this case, an initial audit should be carried out. Next, you need to grab the tongue and move it to the side, conducting a re-examination. If during the revision it is found that there are foreign objects in the oral cavity, they must be removed. After that, the Ambu bag is connected to the mask, which is pressed against the patient's face with the index and thumb fingers, and the remaining fingers and hand are placed on the chin, firmly fixing the mask. Next, you need to intensively compress the bag, pushing the air into the lungs, and remove the mask from the face to exhale. This procedure is repeated until the patient has spontaneous breathing with a frequency of at least 16-18 breaths per minute. Pupil constriction is the main criterion indicating that ventilation of the lungs is carried out effectively.

Using the Ambu bag, it is necessary to monitor the complete tightness of both the device itself and the area where the mask fits to the face. The slightest air leaks will reduce the injected pressure and nullify the entire medical care procedure. You should also pay attention to the correspondence of the volume of the pear to the age of the patient. The increased volume of air pumped into the lungs can lead to barotrauma in a person in need of emergency care.

Indications for use

The main indication for use is respiratory arrest and the need for artificial ventilation. In addition, the bag can also be used in relation to patients with respiratory failure to facilitate inhalation (for example, during an attack of bronchial asthma).

Contraindications

Artificial ventilation of the lungs with an Ambu bag is contraindicated in the presence of foreign objects or masses in the oral cavity. In this case, there is the possibility of aspiration of the latter. In this case, it is necessary to immediately clean the oral cavity and start ventilation.

Conclusion

Conditions that require emergency medical attention and are accompanied by respiratory arrest are not uncommon. At the same time, you have an excellent chance of saving someone else's life if you have an Ambu bag at home or in a car first-aid kit. The price of this device is low and fluctuates around 1500-2000 rubles, depending on the manufacturer.

Ambu bag. After all, this device is not intended for home use.

General information

The Ambu bag is a medical device that is used for such a device is used for those patients who have respiratory problems. This device owes its name to the first manufacturer (Ambu). By the way, it was created in 1956 by engineer Hesse and Professor Ruben specifically to prevent the polio epidemic. However, it is worth noting that today the presented device is quite often referred to as follows: “manual pulmonary resuscitation bag”, “resuscitation breathing bag” or “manual breathing apparatus”.

Where is it used?

As mentioned above, the Ambu bag is not intended for home use. After all, such a device is included in the standard set of reanimobiles, and is also used in departments and anesthesiology. It should be noted that it is quite often used during the operation, before connecting an electrical ventilator.

Main types

Ambu bag has many varieties. In addition, the bag of such an apparatus can be filled with air from the environment and from a connected oxygen cylinder. Quite often, the procedures carried out with the help of this device are compared with artificial respiration, the so-called "mouth-to-mouth". However, in comparison with it, this method is simpler, hygienic and effective.

Currently, manufacturers produce different types of such medical devices, which differ not only in appearance, but also in what material they are made of. For example, a reusable Ambu bag can withstand up to 20 autoclaving cycles, as it is made of silicone. As for disposable devices, most often they are made of PVC.

Ambu bag: how to use?

All doctors and nurses are required to be able to use this device. However, an ordinary person can also master it. To do this, the patient's head is thrown back, the mask of the device is taken with the index and thumb of the left hand, and then applied to the patient's face and pressed, supporting. Then, with the right hand, it is necessary to squeeze the accordion or bag, thereby taking a deep full breath. Exhalation should be passive. In this case, the normal patency of the respiratory tract (upper) is ensured by extending the patient's neck or introducing an air duct into the mouth (possibly into the nose).

In the event that artificial respiration should be carried out during anesthesia, then it is done using a special manual or automatic respirator. To do this, you need to take the mask with your left hand and press it to the face of the victim, holding the lower jaw. The right hand should rhythmically squeeze the breathing bag. In this case, the pressure on the bag should be carried out smoothly, quickly and gently. After reaching the normal rise of the patient's chest, the arm should be lowered and a passive exhalation should be made.

The breathing apparatus, developed in 1956 by the Danish anesthetist professor Henning Ruben and the German design engineer Holger Hesse to prevent mass diseases of poliomyelitis, is most often called the Ambu bag.

The inventors took their earlier development of 1953 as a basis - a suction pump for technical needs. They wanted to create a special pump bag with valves and a flexible breathing mask that could be fixed on the patient's face. They called the new invention Ambu bag (Ambu bag or bag). Later, the company founded by Ruben and Hesse was named after the apparatus.

Description

Since the invention was a real breakthrough in medicine and enjoyed incredible success, the name "Ambu bag" was assigned to all such devices. It is also called:

• respiratory resuscitation bag, pulmonary resuscitation, respiratory respiratory;
• manual resuscitation system;
• pump for artificial lung ventilation;
• manual breathing apparatus.

Not a single standard set of an ambulance resuscitation team, intensive care and anesthesiology departments, rescuers of the Ministry of Emergency Situations can do without it. Used for artificial respiratory support in patients who cannot breathe on their own. For example, with clinical death or during surgery until the patient is connected to an electrical ventilator.

It is either single use or reusable. Divided by type:

• for babies;
• children;
• adult.

The Ambu disposable bag set includes:

1. Anesthesia mask.
2. Breathing bag.
3. oxygen bag.
4. Oxygen tube.
5. Air ducts.
6. Gas inlet connector.
7. Pressure relief valve (may not be).

The mask is made of polycarbonate or polyvinyl chloride, the air ducts are made of polypropylene, and the tubing is made of polyvinyl chloride. The temperature at which you can use the device is in the range from -18 degrees to +50 degrees. It can be stored at temperatures from -40 to +60 degrees.

Operating principle

The mask is pressed tightly against the patient's face with the thumb and forefinger. At the same time, the middle and ring fingers press on the corners of the lower jaw, tilting the patient's head; - fingers of the second hand begin to compress the air bag.

Squeezing movements should be smooth, fast. Through the mask, air begins to flow into the lungs. Exhalation is made into the environment.

Very often, actions using the Ambu bag are compared with one of the types of artificial respiration - mouth to mouth. However, there is no risk of getting infected with anything, and the effect is much greater.

Single Use Benefits:

• no risk of cross-contamination;
• no need for sterilization and disinfection.

Manufacturers

Many Chinese manufacturers are engaged in the production of resuscitation bags. Of the well-known world companies, these are Flexicare (Great Britain) and Westmed (USA). Bags produced by Enter Medical Corp (Taiwan) are popular. In Russia, the production of resuscitation bags is carried out, in particular, by the Moscow company MITK-M.

Disposal

According to the hazard class of medical waste, the Ambu disposable bag belongs to category B (that is, potentially hazardous) and after use must be packed in a hermetically sealed, disposable, non-puncture yellow bag, specially marked. After the mandatory disinfection procedure is carried out, it is taken to a landfill or a medical waste processing plant, where it can be either buried or burned.

The Ambu bag is disposed of in accordance with SNiP No. 2.1.7.2790-10 dated February 17, 2011 "Rules for the collection, storage and disposal of waste from medical institutions."

ambu bag

Operational and resuscitation measures are directly related to the support of the patient's breathing. The ambu breathing bag helps resuscitators save human lives. It provides artificial lung ventilation, has a simple algorithm and simple technique to use. If necessary, they can easily be used by people who do not have a medical education.

What is an ambu bag

The device has become a kind of breakthrough in medicine, so the name is firmly entrenched in all such devices (Figure 1).

Figure 1. External features of the device

The ambu breathing resuscitation bag is a great success, it is also known as:

1. Manual resuscitation system.
2. Pump for artificial lung ventilation.
3. Respiratory mask.
4. Pulmonary resuscitator.

It is a device consisting of a self-inflating balloon and a mask attached to it. Some of its models have the ability to dispense the respiratory mixture.

Many manufacturers supplement the device with a backup set of a different size. In this case, the ambu manual ventilation bag is universal - when resuscitating an adult or a child, it is enough to simply replace the balloon. It is made from non-allergenic materials - for reusable use, the mask is treated with a disinfectant.

The ambu-type breathing bag is used by: ambulance teams, employees and rescuers of the Ministry of Emergency Situations, in intensive care units, anesthesiologists and resuscitators.

The main use of the ambu bag is in situations associated with impaired respiratory functions:

1. For patients who cannot breathe on their own.
2. In perinatology - in order to resuscitate newborns.
3. During clinical death or surgery until connected to an electrical ventilator.

The ambu bag ventilator can be of several types:

• single or multiple use;
• for newborns and children whose body weight does not exceed 10 kg;
• pediatric - for those whose weight is in the range of 10-40 kg;
• adult - for patients weighing more than 40 kg.

The principle of operation of the ambu bag

For all its simplicity, the device is quite effective and reliable. An ambu resuscitation bag, the use is based on the principle of manually squeezing a balloon from which air comes out. It is sent directly to the respiratory tract, and a mask through which oxygen passes is superimposed on the patient's face (Figure 2).

Figure 2. Design and principle of operation

The breathing resuscitation ambu bag allows you to saturate the lungs only if the airways are passable, there are no obstacles in the form of vomit and foreign bodies, the tongue is in the larynx and other causes of obstruction.

For connection to the respiratory tract, it comes with various adapters:

1. Tracheostomy or endotracheal tube.
2. Laryngeal or facial mask with an air duct.
3. After attaching to them, the operator rhythmically squeezes the walls of the bag.
4. The interval depends on the clinical situation - approximately 12-20 times per minute.
5. Operating temperature ranges from -18 to +50 degrees Celsius.

These accessories have a standard hole diameter that allows the device to be connected to them as tightly as possible.

Disposable

In emergency situations and at field events, one-time samples are used. The disposable ambu silicone bag is completed with an anesthetic mask, oxygen and breathing bags, a gas inlet connector, air ducts and an oxygen tube, and a pressure limiting valve - optional.

Since the mouth-to-mouth breathing technique allows the risk of infection with something, and the volume of the lungs of a child is smaller than that of an adult, the ambu bag for children, for newborns, implies only a single use, has the same characteristics with smaller sizes (Figure 3).

Figure 3. Disposable bags are predominantly used for neonates

It provides much greater ventilation efficiency, eliminates the need for sterilization and disinfection, and eliminates the risk of cross-contamination. In addition, his mask is made of polycarbonate, the bags and tube are made of polyvinyl chloride, and the air ducts are made of polypropylene. It cannot be reused.

reusable

Can be found in every medical facility or ambulance. The reusable ambu bag is used in the provision of resuscitation care at the scene, in the vehicles of resuscitation teams when transporting patients and before connecting patients to an electronic ventilator (Figure 4).

The ambu bag mask is a reusable element, therefore, it is subject to increased requirements for sterility and processing.

At the same time, the reusable ambu bag itself is necessary exclusively for temporary ventilation, since it does not allow monitoring the volume of supplied air, does not have airway pressure control and requires constant manual participation in the process.

Figure 4. This is what reusable devices look like

Ambu bag reusable adult differs from children:

1. The large volume of the cylinder and the need for disinfection.
2. Oxygen supply lines and filters, CO2 indicators can be connected to it.
3. Some variants have ports for injecting special aerosols.
4. They can be used to relieve bronchospasm as a spacer.

Respiratory arrest can occur in a wide variety of situations, often during complex operations. Ventilation of the lungs with a manual ambu bag in such cases occurs before a person is connected to an electric ventilator and can save a human life due to a simple mechanical effect. In addition, it provides an easy and reliable supply of clean or oxygen-laden air and is standard on resuscitation vehicles, intensive care units, and operating rooms (Figure 5).

Ambu bag ventilation is more hygienic than mouth-to-mouth breathing.

This is the simplest way to deliver airflow to the lungs due to the simple design of the product. In fact, it is a small hand-held mechanical device that is convenient in terms of transportation, if necessary, take emergency measures.

Figure 5. The principle of lung ventilation

Artificial ventilation of the lungs ambu bag is as follows:

1. The mask is pressed against the victim's face with the thumb and forefinger.
2. The middle and nameless ones are pressed on the corners of the lower jaw, throwing back his head.
3. Smooth, squeezing and quick movements of the fingers of the free hand compress the air reservoir.
4. Air enters the lungs directly through the mask, exhalation is made into the environment.

Ambu bag - instructions for use

Anyone can use the device, even if he has no medical training (Figure 6).