Can it be done?

[JoelEMT]

I was in a scenario for my provincial registration and had a pt who had to be bagged. Said pt was suffering from pulmonary edema. So I tried bagging the pt in a semi-Fowler's position (as I was taught both in classroom and on practicum.) (said pt was also conscious at the time and would not, obviously, lay down.)

Now, the $64 question is Can it be done effectively?

I failed the scenario due to this while others claim to have done the same thing and yet passed none the less.

Not looking to find out if I was wronged, I just want opinions as to whether it can be done effectively.

Note: This was a BLS scenario.

[Ridryder 911]

It depends on the rescuer & the patient..I have successfully done this many times. As long as you can maintain an open airway ( I usually use a neck-roll) & be ventilate the patient. I prefer this method when performing PEEP using the BVM device.

Also, remember CPAP & patients on ventilators are in this position at times, & does not require the patient to be in a supine position.

Be safe,

Ridryder 911

[craig]

if the patient was conscious and needed ventilation due to oedema

there is nothing wrong with sitting them upright on the bed and ventilating them from behind.

you don't need to be supine to bag some one

stay safe

[ResQBtheEMT]

I agree - as long as you can maintain an airway and get a good seal with the BVM there is nothing wrong with leaving the patient sitting upright. Being supine is not an absolute requirement...

[Guest]

Rather ventilating a pt supine or semi fowler, which both can be done effectively, if you maintain the airway--with a good seal easier with two man ventilation's.

[limbstruck]

I have never seen a patient in pulmonary edema (alert) that will lay back, most of them I have seen swing those legs over the side and are tripoding like there is no tomorrow.

[kemt217]

Good luck getting a pt w/ pulmonary edema to lay supine to bag them. As long as you have a good seal then bagging the pt semi-Fowler's isn't a problem.

[Alcomedicism]

I have usually been told if a pt with a pulmonary edema, you can raise them to a 30 degree angle and still effectively bag them, just watch your airway and maintain a good seal. This is all coming from a rookie, so you're warned!

-Alcomedicism

[ERDoc]

Although I haven't had the opportunity to try it, I have seen anesthesiologist intubate a pt in a near upright position. They say that the airway is much easier to visualize and is more of a straight line. I have actually seen them jump up on the back of a hospital stretcher and do it standing about 3-4 feet off the ground. I can only assume that the airway is more patent in the sitting position, even for bagging. I have had the opportunity to bag someone in the sitting position and didn't have any problems. You just have to make sure that you bag when they inhale.

[Off Label]

Hand ventilation sitting up is more easy and effective than supine in most any patient. The problem is venous return....