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From: "Caple, Dene R." <DRCaple@uw*.ac*.uk*>
To: techdiver@aquanaut.com
Subject: RE: [Fwd: Re: Positive Pressure Oxygen]
Date: Thu, 25 Nov 1999 14:17:16 -0000
I missed the first half of this thread so Im sorry if Im covering things
already said or if Ive gotten the wrong end of the stick.

If the argument behind using a reg for resusitation is that the tank my
contain a high % of O2.  If this is the case then cant the rescuer take a
breath and then perform normal mouth to mouth?  Surely the nominal loss in
O2 would outweigh the damage that may be caused using a reg?  This may be
more difficult and complicate an already stressful situation but it may be
less harmful.

Dene 

http://www.neoprene-dreams.co.uk

> -----Original Message-----
> From:	David Reinhard [SMTP:reinhard@oc*.co*.au*]
> Sent:	Friday, November 26, 1999 2:54 AM
> To:	techdiver@aquanaut.com
> Subject:	Re: [Fwd: Re: Positive Pressure Oxygen]
> 
> >> These people are starting to piss me off ...
> >> 
> >> I agree 100% on the use of the reg for resuscitation ...
> >> Anybody who can't see the advantages ...
> 
> Only if you choose to ignore the disadvantages.
> 
> >> especially if you have a high 02 mix ????????
> >> 
> >> What is this nonsense they are spouting about compleatly sealing the
> reg
> >> exhaust?
> >> With the nose sealed and a good mouth seal ...
> 
> The gas will take the path of least resistance - out the exhaust ports.
> 
> >> An unconscious lung will inflate if the airway is open ...
> >> Sealing the exhaust ports would be dangerous.
> 
> Yes. If you don't manage to rupture the lungs you may well inflate the
> stomach.
> 
> >> I know you can inhibit flow out the exhaust with your fingers for
> obvious
> >> reasons ...
> >> But compleatly sealing it would be dangerous because of the positive
> >> pressures you could generate.
> >> My LSP surface rescitator unit (pos Pressure)has an exhaust system in
> the
> >> resuscitator head that works just like a reg exhaust ...
> >> What's the difference?
> 
> The difference is clear and obvious. The pressure relief valve on a
> positive pressure resuscitator is set at around 50-70cm H2O. This is
> designed to prevent overpressuring the lungs but still provide enough
> pressure to overcome the resistance of the airways and chest compliance.
> If
> the pressure is significantly less than this you will not inflate the
> lungs. If the pressure is greater than this then you will damage lung
> tissue. A reg has no way of ensuring that you deliver the appropriate
> pressure. Exhaust ports are designed to provide absolute minimal
> resistance
> (low exhalation effort is just as important as low inhalation effort in a
> good reg). It is therefore unlikely that you will achieve adequate
> pressure
> to overcome airways resistance...it is just too easy for the gas to escape
> through the exhaust ports. If you have a very high flow rate when purging
> then maybe (just maybe) some of the gas will find its way into the lungs.
> But you will have no way of regulating this or knowing if the amout that
> went in (if any at all) is adequate or too great.
> 
> >> 
> >> Thought I'd  pass these references along ...
> >> I'm sure your alredy aware of a lot of it ...
> >> I haven't had a chance to look at any of them yet myself ...
>  
> How very clever! You typed a key word (probably Resuscitators or something
> similar) into Medline and hit "search". Wow...I am impressed. It is such a
> pity that none of the articles appear to have anything to do with the
> topic
> in question (ie scuba regs for resus) You may as well have typed in
> "wanking machine" or "butt licking"...just as much use and probably a lot
> more fun to read.
> 
> (Actually I am being a bit flipant. There are a number of articles here
> that would probably be of interest to me in my profession...except I
> already have about 30 articles on various topics that are awaiting reading
> when ever I manage to get the time. However in terms of this specific
> debate I do not see any articles that will answer the question being
> asked...therefore it is a waste of time and bandwidth since they are
> irrelevant to the debate.) 
> 
> >> This one caught my eye ...
> >> Corley M, Ledwidge MK, Glass C, Grap MJ.
> >> The myth of 100% oxygen delivery through manual resuscitation bags.
> >> J Emerg Nurs. 1993;19:45-9.
> >> 
> 
> This one caught MY eye...
> 
>  Hartstein AI, Rashad AL, Liebler JM, et al. Multiple intensive care unit
>  outbreak of Acinetobacter calcoaceticus subspecies anitratus respiratory
>  infection and colonization associated with contaminated, reusable
> ventilator
>  circuits and resuscitation bags. Am J Med. 1988;85:624-31.
> 
> 
> Obviously this is the definitive word on using regs for resus!! You can
> tell just by reading the title! This article will be packed with
> information every diver come rescuer must know before using a reg to purge
> someone!!
> 
> So where do we stand...so far not one authoritative comment or article in
> support of regs for resus. I am waiting...but losing patience (but at
> least
> I am not losing my 'patients'!).
> 
> David
> 
> 
> 
> >> All the Best ...
> >> 
> >> Marty H    Canada
> >> 
> >> P.S. Beginning to understand why you call these people strokes
> >>      Feel free to distribute this message if I'm not out to lunch on
> this
> >> ...
> >> 
> 
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