1. Delivering Free-flow Oxygen
Oxygen mask
Flow-inflating bag and mask
T-piece resuscitator
Oxygen tubing

2. Free-flow Oxygen Given Via Oxygen Mask

3. Free-flow Oxygen Given Via Oxygen Mask

4. Free-flow Oxygen Given Via T-piece Resuscitator

5. Free-flow Oxygen Given Via Oxygen Tubing

6. Free-flow Oxygen Given Via Oxygen Tubing

7. Types of Positive-Pressure Devices
Self-inflating bag
Flow-inflating bag (anesthesia bag)
T-piece resuscitator
Types of Positive-Pressure Devices

8. Self-inflating Bag

9. Self-inflating Bag

10. Flow-inflating Bag

11. T-piece Resuscitator

12. Safety Features: Self-inflating Bags With Pressure-release Valve

13. Safety Features: Flow-inflating Bag

14. Safety Features: T-piece Resuscitator

15. Resuscitation Masks Resuscitation Masks Rim Shape Size - Cushioned
- Non-cushioned
Shape
- Round
- Anatomically shaped
Size
- Small
- Large
Resuscitation Masks

18. Resuscitation Masks: Round Shape
Disadvantages
If the correct size is not selected, a seal can not form
If the mask is too large, eye damage may develop

19. Resuscitation Masks: Anatomically Shaped
Advantages
Easier to obtain a seal
Less chance of eye damage

20. Resuscitation Masks Size Mask should cover Small Large Tip of chin
Mouth
Nose

21. Resuscitation Masks: Size
The correct size will cover the tip of the chin, the mouth, and the nose but not the eyes.
Too large → Eye damage
Too small → Will not cover the mouth and nose and may occlude the nose.

24. Size of Bag
Bags used for newborns should have a volume of 200 to 750 mL. Term neonates only require 15 to 25 ml with each ventilation (5-8 mL/kg).

25. Preparation Checklist
Before beginning PPV:
Select appropriate-sized mask
Be sure airway is clear
Position baby’s head
Position yourself at baby’s side or head

26. Positioning Mask on Face

27. Ventilation Rate
40-60 breaths per minute

28. Signs of Improvement Signs of Improvement
Improvement is indicated by the following signs:
Increasing heart rate
Improving color
Spontaneous breathing
Improving muscle tone
Signs of Improvement

29. Infant Not Improving and Chest Not Adequately Expanding
Possible causes
Inadequate seal
Blocked airway
Inadequate pressure

30. Causes and Solutions for Inadequate Chest Expansion
Conditions
Actions
1.Inadequate seal
Reapply mask to face and lift the jaw forward.

31. Causes and Solutions for Inadequate Chest Expansion
Reapply mask to face

32. Causes and Solutions for Inadequate Chest Expansion
Lift the jaw forward

33. Causes and Solutions for Inadequate Chest Expansion
Conditions
Actions
2. Blocked airway
Reposition the head.
Check for secretions; suction if necessary.
Ventilate with the newborn’s mouth slightly open.

34. Causes and Solutions for Inadequate Chest Expansion
Conditions
Actions
3. Inadequate pressure
Increase pressure until there is a perceptible movement of the chest.
Consider endotracheal intubation.

35. Continued Positive-Pressure Ventilation
Orogastric tube should be inserted to relieve gastric distention
Gastric distention may
Elevate diaphragm, preventing full lung expansion
Cause regurgitation and aspiration

36. Continued PPV

37. Insertion of Orogastric Tube
Equipment
8F feeding tube
20-mL syringe

38. Insertion of Orogastric Tube
Measuring correct length

39. Insertion of Orogastric Tube
Insert tube through mouth. Resume ventilation
Attach 20-mL syringe and aspirate gently
Remove syringe and leave tube end open to air
Tape tube to newborn’s cheek
Insertion of Orogastric Tube