While performing CPR on a cardiac arrest victim, the therapist is ventilating the patient with a bag-valve-mask manual resuscitator, and is delivering pressures between 30 and 35 cm H2O to the patient's airway. What should be this therapist's concern?
A. overdistention of the patient's lungs
B. gastric insufflation
C. under inflation of the patient's lungs
D. No is necessary because these pressures are harmless.
ANS: B
A. Incorrect response: See explanation B.
B. Correct response: A factor affecting delivered Vt during CPR is esophageal opening pressure. Because airway pressure is increased to deliver volume in the face of increased pulmonary impedance, gastric insufflation results. Based on work by Rueben and associates, esophageal opening pressure is approximately 20 cm H2O. Airway pressures of 30 to 35 cm H2O will likely produce gastric insufflation. The use of longer inspiratory times and slower flows is recommended to prevent gastric insufflation.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B
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