MD DA DNB PhD FICA IDRA Diploma in software based statistics Anesthesia face masks Anaesthetic facemasks are designed to fit over the patients nose and mouth and enable the creation of a low ID: 1046824
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1. Face masks Dr S.Parthasarathy MD., DA., DNB. PhD., FICA., IDRA.Diploma in software based statistics
2. Anesthesia face masks Anaesthetic facemasks are designed to fit over the patient’s nose and mouth and enable the creation of a low pressure seal. This should not require excessive forceIf we go to history – it is big and incomplete
3. How the masks came into being from 1850s !!
4. Roth mask, wire frame Ochsner mask, Foregger type mask with cushion
5. Esmarsch and kirscoff – round Trough for excess liquid
6. Schimmelbusch mask- oval trough
7. When I searched in Google for face masks !!
8. Basic uses Give gases NIV Rubber Plastic Polycarbonate Elastomeric Combination Made of ??
9. Earlier what was ?? Natural latex rubber is extracted from the bark sap of rubber plants as the monomer C5H8.cheap and versatile, it degrades easily and is contaminated by plant proteins that are the cause of allergic reactions in susceptible individuals.Synthetic latex nowadays – can be autoclaved – like neoprene
10. The most common plastics are polyethylene and polyvinyl chlorideCant heat – but mouldable, allergogenic Cuff ?? Mould, warm -- PVC is more suitable. PVC is brittle on its own but can be made in varying degrees of softness by the addition of plasticizers
11. Parts of the mask Body Seal Connector
12. Body !! Body – rubber , plastic or polycarbonate In some cases, a malleable wire stiffener or wire gauze is incorporated in the body so that the shape may be altered to fit the patient’s face.
13. Body transparent The transparent body of a polycarbonate or plastic facemask permits continuous inspection of the airway and respiration to be monitored by the appearance of condensation during exhalationVomiting and regurgitation – can be seen Less frightening to children
14. Body and dead space !! The internal volume (apparatus dead space) within the body of the facemask is relatively unimportant in adults but may assume significance in neonates and infants where it can constitute 30% or more of their tidal volume.Several designs shape the paediatric facemask to minimize the apparatus dead spaceAdult masks may be 70 – 100 ml !!
15. Seal or mount The mount should be a 22 mm female taper if made to the standards of ISO… A ring with hooks( harness hooks) may be placed around the connector to allow a mask strap to be attached. Metal or plastic hooks
16. The face mask harness (e.g., Boothby and Cotton, Gwathmey–Woolsey, Clausen) Was a necessity, because anesthesia with cyclopropane and nitrous oxide with a closed circuit required a perfect seal with the patient’s face
17. Straps – harness
18. Seal Cuff seal Extended body which is flexible and compressible Prefilled seal Inflatable seal
19. Rendell baker 00, 0, 1, 2, 3.mask has been used for the patient with a tracheostomy and a patient with acromegaly . It may also be useful when a mask to cover only the nose is needed4 ml DS 8 ml DS 3 ml DS 12 ml DS
20. Routine is called anatomical connell flattened mask Trimar mask Less dead space
21. PVC single use Color coded Rounded Pediatric masks
22. Ambu transparent body mask Thumb rest Inflatable rim
23. LaerdalThe Laerdal Pediatric Pocket Mask makes CPR on pediatric patients safer. With the low resistance one way valve, and circular silicone mask for pediatric features, providers can provide better, safer CPR to Pediatric patients.
24. single-use masksdo not allow adjustment of the volume of the air-filled cuffs.poor-quality seal. Poor design or poor fit can cause areas of high pressure on the skin, which if unchecked, could lead to ulceration.
25. But !! include use of inert plastics (eliminating risk of allergy to latex), transparency to add scent to the plastic making the products more readily accepted by patients
26. Scented masks Anesthesia induction and preoxygenation comfortable Manufacturer Or anesthesia provider ethyl alcohol may hinder agent monitoring devices
27. Endoscopic mask.
28. Patil-Syracuse mask additional port with a soft silicone membrane to accommodate different endoscopic devices. The port can be closed off with a plastic cap. The Patil-Syracuse mask is re-usable and can be autoclaved.
29. Ages Weight Nose Edentulous
30. Technique -One-hand MethodTwo fingers on either side Three fingers down Slight pressure Left palm can push Leak may be there
31. Supported one hand !! submaximal head extension generated between fingers one and three, the little finger felt the facial artery pulse, and themiddle, ring, and little finger felt for tracheal vibrations and swallowing
32. Two handed Esmarch-Heiberg maneuver, which involves dorsiflexion at the atlanto-occipital joint and protrusion of the mandible anteriorly by exerting a forward thrust on the ramiChin in elbow of mask
33. Anes stands by the side The face mask is applied to the face by using the right hand with the palmer surface facing upward. The ring finger goes under the angle of the jaw, and the middle finger is placed under the angle of the jaw on the left. The index finger and thumb encircle the body of the mask. The anesthesia provider then tightens the grip on the mask to achieve a good fit. The little finger is kept free.Claw holding technique
34. Lot of designed masks for dental anesthesia
35. EC clamp technique Three fingers as E Two fingers as C
36. Shetti maneuver – keep shoulder for stability
37. Bearded fellows Clean shave Plastic shield over the beard Cut a hole in the rubber – old earth plate of diathermy Small nasal mask
38. Please don’t bother much about dead space If we press hard , it may be ;less What is fitting – go ahead
39. Difficult Face Mask Ventilation5% to 6% of anesthetics facial characteristics (fat, emaciated, and edentulous faces as well as those with prominent nares, burns, flat noses, receding jaws)Ryles tube in Predictors of difficult mask ventilation include male gender, a beard, lack of teeth, age over 55 years, macroglossia, high body mass index, a history of snoring, increased Mallampati score, and low thyromental distance
40. Edentulous Buccinator weak Teeth absent Shrinking angle of mouth Weak neck muscles
41. Advantages No tube No LMA Cheap
42. Complications Hand in use FatigueHigh flows and pollution Skin problems ( allergy) Nerve injuries – straps Aspiration Eye injury Gastric inflation
43. Dr Ravishankar quotation ?? If you can hold beer glass , yes !! you will be comfortable with face masks !!
44. Thank you all