This document discusses positive pressure ventilation for compromised newborns during resuscitation. There are two types of resuscitation bags - flow inflating bags and self inflating bags. Flow inflating bags require an oxygen source and tight seal to inflate properly, while self inflating bags can deliver positive pressure without an external oxygen source but require a reservoir to provide 100% oxygen. The document also covers recommended bag sizes, pressure valves, masks and testing procedures for the bags.

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. Flow inflating bag
 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. Self inflating bag
 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