Ambu Bags for CPR – What, Why, and How to do CPR with an Ambu Bag

What is an AMBU Bag?

An AMBU is short for Artificial Manual Breathing Unit bag. AMBU Bag is also known as a bag-valve-mask (BVM) device or manual resuscitator. In simple terms, an AMBU bag is a hand-held medical tool used to push air into the lungs of patients who are not breathing or are struggling to breathe adequately. The AMBU bag consists of a self-inflating bag, a unidirectional valve, and a face mask.

The bag is connected to a face mask, which is placed over the patient’s nose and mouth to create a seal. The seal ensures that the air or oxygen delivered by the bag reaches the patient’s airway effectively. These bags allow healthcare providers to manually assist or stimulate breathing in various medical scenarios, including CPR during cardiac arrest, choking, or drowning.

What are the components of the AMBU Bag?

An AMBU bag typically consists of several key components designed to facilitate manual ventilation and resuscitation:

• Bag: The bag is the main part of the device. It is usually made of silicone or other flexible materials. The bag is squeezed to deliver breaths to the patient. It’s a flexible and collapsible reservoir that delivers positive pressure ventilation to the patient’s lungs.
• Mask: A face mask (or sometimes an adapter for an endotracheal tube) is placed over the patient’s nose and mouth to create a seal for effective ventilation. It covers the patient’s nose and mouth, creating a seal to ensure effective delivery of breaths and prevent air leakage.
• Valve System: The valve system includes inspiratory and expiratory valves that control the direction of airflow. The inspiratory valve opens to allow air or oxygen into the bag during compression, while the expiratory valve directs exhaled air away from the patient to prevent rebreathing.
• Peep Valve (Optional): Some models may include a PEEP valve (Positive End-Expiratory Pressure valve) to maintain a small amount of pressure in the patient’s airways and lungs at the end of exhalation. Peep valve helps to keep the alveoli open, improve oxygenation, and prevent from lung collapse.
• Oxygen Reservoir: Oxygen Reservoir is a capacity within or attached to the bag. Reservoir stores oxygen for delivery during ventilation. It ensures a consistent oxygen concentration.
• Reservoir Bag (Optional): In some designs, a reservoir bag is attached to the AMBU bag. These bags store additional oxygen and help deliver a more consistent tidal volume during ventilation.
• Connectors and Tubing: These connectors allow for connection to supplemental oxygen sources, endotracheal tubes, or other ventilation accessories to ensure flexibility in respiratory support.

What Are Ambu Bags Used For?

Ambu bag is often used during emergencies like cardiac arrest or when someone has trouble breathing due to asthma attacks or drug overdoses. It’s an essential tool for keeping people alive in critical situations where every breath counts. Ambu bag is commonly employed in various emergency situations like drowning and trauma cases as well. In addition to emergencies, the Ambu bag is used in anesthesia to assist with ventilation during surgery and transporting patients when mechanical ventilators are unavailable. Its simplicity and effectiveness make it a critical component in hospitals, ambulances, and other medical settings where quick intervention can mean the difference between life and death for patients.

When Do You Use an Ambu Bag?

An AMBU bag is used in the following situations:

• When a patient is not breathing (apnea)
• When a patient has inadequate breathing due to medical conditions like COPD, asthma, or during anesthesia
• During cardiopulmonary resuscitation (CPR) in cases of cardiac arrest
• In emergencies like drowning, choking, or drug overdose
• During patient transport in ambulances or within hospitals when mechanical ventilators are not available.

What is a Peep Valve on an Ambu Bag?

A PEEP (Positive End-Expiratory Pressure) valve on an Ambu bag is a component that controls the amount of pressure maintained in a patient’s lungs at the end of exhalation. This pressure is maintained above atmospheric pressure at the end of each breath, preventing the collapse of alveoli (tiny air sacs in the lungs) and enhancing oxygenation. By keeping the alveoli open during the respiratory cycle, PEEP improves oxygenation, prevents lung collapse, and optimizes the exchange of oxygen and carbon dioxide.

This feature is crucial in managing patients with respiratory conditions where maintaining adequate lung volume and function is essential for patient recovery. In clinical settings, the PEEP valve can be adjusted to specific pressure levels depending on the patient’s needs. This adjustment contributes to respiratory support and better patient outcomes.

Working of an AMBU BAG?

The AMBU bag works by delivering positive pressure ventilation to the patient. Here’s a step-by-step breakdown of its operation:

• The mask is placed over the patient’s nose and mouth, creating a tight seal.
• The healthcare provider manually compresses the bag, forcing air through the one-way valve into the patient’s lungs.
• After compression, the bag automatically re-expands by drawing in ambient air (or oxygen if connected to an oxygen source) through a separate inlet valve.
• The patient exhales passively, and the exhaled air escapes through a separate valve, preventing the re-breathing of carbon dioxide.

How to Perform CPR with an Ambu Bag Correctly in Emergency Situations?

To perform CPR using an AMBU bag, you need precision and must follow proper techniques. If you adhere to the correct methods, it helps to ensure effective ventilation and resuscitation. Here are the correct steps to perform CPR with an AMBU Bag in emergencies:

• Step 1: Make sure the patient’s airway is open. Use the head-tilt, chin-lift maneuver, or jaw-thrust maneuver if a spinal injury is suspected.
• Step 2: Place the mask over the patient’s face, covering both the nose and mouth, ensuring a tight seal.
• Step 3: Squeeze the bag with both hands for adults (one hand may suffice for infants and small children) to deliver breaths. Each breath should last about one second, and the rise of the chest should be observed to confirm adequate ventilation.
• Step 4: During CPR, for adults, deliver 30 chest compressions followed by 2 breaths. For children and infants, use a 15:2 ratio if two rescuers are available.
• Step 5: Continue ventilation until breathing resumes or advanced medical help takes over.

Why is the AMBU Bag so important in Emergency Care?

AMBU bag is a vital tool during emergency care for so many reasons. First of all, it helps to provide immediate assistance to patients who are not breathing or are breathing insufficiently. Using the AMBU bag on time helps to prevent potential brain damage. Similarly, an emergency can occur anywhere, and it can be used in various settings, from pre-hospital environments to hospital critical care units. AMBU bag is also lightweight, portable, and easy to use with minimal training. Therefore, it can be used by both professional healthcare providers and trained lay rescuers to help in resuscitation efforts. Moreover, AMBU bags are designed with features like adjustable PEEP valves and oxygen reservoirs, further enhancing their usage in managing complex medical emergencies with precision and care.

FAQS About AMBU Bags

What does AMBU Stand for?

AMBU stands for “Artificial Manual Breathing Unit.”

Can anyone use an AMBU bag?

Yes, anyone can use AMBU bags. These bags are designed to be used by trained healthcare professionals and lay rescuers in emergencies. They require basic training to ensure proper technique and effectiveness.

Is the AMBU bag reusable?

Yes, AMBU bags are generally reusable after thorough cleaning and disinfection between uses. The components like the bag, mask, and valves can be cleaned according to manufacturer guidelines to maintain hygiene and functionality.

What is another name for an Ambu bag?

The another name for an Ambu bag is a “manual resuscitator” or “bag-valve-mask (BVM) device.”

How many breaths do you give with an Ambu bag?

During CPR, the recommended ratio for using an Ambu bag is 30 chest compressions followed by 2 breaths for adults. The ratio may vary for children and infants, typically 15 compressions to 2 breaths if two rescuers are available or per guidelines based on the patient’s size and condition.