Crank up the Oxygen and Skip the Bag-Valve-Mask

Preoxygenation is a key step in rapid sequence intubation and involves allowing the patient to breath spontaneously with supplemental oxygen. The classic method, thought to achieve the highest alveolar oxygen concentration, is to use a bag-valve-mask (BVM) with high-flow oxygen and a good mask seal but no positive pressure (i.e., no squeezing of the bag). These investigators assessed whether preoxygenation with a nonrebreather mask delivering high-flow oxygen is noninferior to preoxygenation with a BVM delivering oxygen at 15 L/minute.

Twenty-six healthy volunteers were preoxygenated with each of four methods in random order: nonrebreather mask with 15 L/minute oxygen flow; nonrebreather mask with the wall-mounted oxygen valve wide open (>40…