2. Positive pressure ventilation Ventilation of the lungs single most important and most effective step in cardiopulmonary resuscitation of the compromised newborn

3. A good resuscitation bag Size 200-750 ml Capable of avoiding excessive pressure A pressure pop-off valve and/or a pressure gauge manometer Capable of giving 100% oxygen Appropriate sized mask

4. Resuscitation bags Two types Flow inflating bag (anesthesia bag) Self inflating bag

5. Flow inflating bag

6. Fill only when oxygen from a compressed source flows into them Depend on a compressed gas source Must have a tight face-mask seal to inflate Use a flow-control valve to regulate pressure- inflation

7. Flow inflating bag will not work if The mask is not properly sealed over the newborn’s nose and mouth There is a tear in the bag The flow-control valve is open too wide. The pressure gauge is missing

8. Flow inflating bag Advantages Delivers 100% oxygen at all times Easy to determine the adequacy of seal “Stiffness” of lungs can be felt Can be used to deliver 100% free flow oxygen

9. Flow inflating bag Disadvantages Requires a tight seal to remain inflated Requires a gas source to inflate No safety pop-off valve Requires more experience

10. Self inflating bag

11. Fill spontaneously after they are squeezed, pulling oxygen or air into the bag Remain inflated at all times Can deliver positive-pressure ventilation without a compressed gas source; user must be certain the bag is connected to an oxygen source for the purpose of neonatal resuscitation Require attachment of an oxygen reservoir to deliver 100% oxygen

12. Without Reservoir

13. With Reservoir

14. Self inflating bag Advantages Does not need a gas source to inflate Pressure release valve Easier to use

15. Self inflating bag Disadvantages Will inflate even without adequate seal Requires a reservoir to deliver 100% oxygen Can not be used to deliver 100% free flow oxygen

16. Masks Cushioned/Non-cushioned Round/Anatomical shaped Size 0 or 1

17. Correct position of mask

18. Testing the self-inflating bag Squeeze against your palm Pressure felt Pressure release valve Pressure manometer Re-inflation