Use a Non-Rebreather Mask for Preoxygenation for Rapid Sequence Intubation

With flush-rate oxygen, a non-rebreather mask was at least as good as a bag-valve-mask, and notably better when the BVM had a leak.

Many intubators using the rapid sequence intubation protocol use a bag-valve-mask (BVM) for preoxygenation. But in the absence of a good mask seal, a BVM may not be superior to a non-rebreather mask (NRBM). In two crossover studies in healthy volunteers, investigators compared these devices using flush-rate oxygen (supply valve wide open) and measuring expired oxygen (FeO₂) after preoxygenation as the primary outcome. Each study enrolled about 30 volunteers and each participant served as his or her own control.

The first study assessed preoxygenation using the two devices (modified with a 1-way exhalation port) with and without a simulated mask leak. Mean FeO₂ values were 81% for the NRBM, 76% for the BVM, and 30% for the BVM with a mask lea…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Use a Non-Rebreather Mask for Preoxygenation for Rapid Sequence Intubation

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Reviewing Author