How to generate constant CPAP with a BVM for Preoxygenation and Reoxygenation

Richard Levitan and I just got our preoxygenation article accepted to Annals of EM. This video describes one of the concepts in the paper.

Email me if you need further explanation.

Here’s the Video:



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  1. says

    December 2011? It’ll be tough competing with: GW Hendey, A Avila. The Captain Morgan Technique for the Reduction of the Dislocated Hip (Brief Research Report).

    Looking forward to the article!

  2. Mark says

    Pretty darn cool! Although I think it will blow some minds that a nasal cannula can be used at rates of up to 15 lpm :)

  3. Minh Le Cong says

    Levitan and Weingart making emergency airway management safer the world over!
    You guys rock!
    Thanks from down under.
    I used these principles on my last severe pneumonia case recently…she had SaO2 88% on 15Lmask. with CPAP and nasal cannula ..she was100%….during the whole RSI ..she never dropped lower than 98%
    It works

  4. says

    Nice video Scott,

    I love PEEP valves on my BVM. Adding NPO2 @ 15lpm is a great touch.

    On a side note, I’d be drawing a distinction between my resus patient exhaling and “expiring”. Context, context. :>)

    Take care


  5. Joseph says

    I read your annals paper with great interest.

    The table “Sequence of Preoxygenation and Prevention of Desaturation” seems to specifically indicate the nasal cannula should not be connected to oxygen during the preoxygenation period. This appears to be discordant with the video – and as you nicely explained would lead to PEEP only being provided during expiration. Can you please clarify why that was included in your paper?

    Thank you

  6. Jeff says

    Great review article, would like to incorporate this method into our pre-hospital RSI program to buy us more safe apnea. Wondering if there is a concern for denitrogenation-related atelectasis with this method and if so how much of a concern would it really be?
    Thanks for a great resource!!

  7. Shawna Bellew M.D. PGY2 says

    Hey Scott, I was wondering if this is true if you are using flow inflated bags instead of self-inflated bags, We use anesthesia bags in our department, and I’m thinking that because we have constant flow (no actual expiration vale) on these bags that they provide constant PEEP. Is that an accurate assumption?

    • says

      yes it is. I did a discussion on Mapleson Circuits as one of the wees. Problem is most are non-calibrated and I think rebreathing increases with PEEP on these bad boys.


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