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Frequently asked questions
ButterflyBVM Frequently Asked Questions
Hold the device so that you can clearly see the indicator arrows from a top-down view (see below).
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Then squeeze and hold the bellows compressed.
Rotate the tidal volume dial to the desired setting.
Release the bellows (see below).
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Remember the acronym M – V – P
Mask – first, troubleshoot your mask seal
Volume – then if you still don’t have chest rise, go up one or two settings on your tidal volume
Pressure – if you still aren’t getting adequate chest rise, you can then go up on your peak inspiratory pressure by turning the dial to a higher setting.
Remember if you later intubate the patient, you should consider going back down on the device’s tidal volume and peak pressure settings.
It doesn’t. The dial on top is a Peak Inspiratory Pressure (PIP) dial. It controls the maximum amount of pressure a patient’s lungs will experience during compression of the BVM. PEEP is pressure left in a patient's lungs at the end of exhalation when the BVM is released. They are controlled in different ways with the ButterflyBVM™. The following charts may help:
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When in doubt, it is advisable to leave the PIP dial on its factory setting of 40cmH2O.
However, there may be clinical scenarios where other pressures could be helpful for a patient. For example, the Neonatal Resuscitation Program recommends a starting peak inspiratory pressure of 20-30cmH2O when caring for neonates. By contrast, when caring for extra-large adults, inspiratory pressures of 60cmH2O or higher may be needed to achieve adequate ventilation.
According to the American Heart Association and European Resuscitation Council, the standard recommended respiratory rate for most adult patients during a resuscitation is 10 breaths per minute. The ButterflyBVM™ has been tuned to be able to give a maximum of up to 16 breaths per minute while on the large adult setting, up to 21 BPM on the medium adult setting, and up to 26 BPM on the small adult setting all while compressing with just a single hand. Pediatric rates on the device are even faster than this. If you needed to deliver breaths even more rapidly than these rates, this can be done with the ButterflyBVM by using two hands to pull the arms of the device apart between breaths. Doing this will enable a rate of over 30 BPM on the large adult setting with even faster rates achieved on smaller patient settings. However, this option should only be considered in rare circumstances, such as when caring for a patient in acidosis.
Thus, the ButterflyBVM™ will discourage a user from delivering breaths at a dramatically elevated rate while allowing for strategic hyperventilation in select patients when needed.
Users should always personally monitor the rate at which they deliver breaths to patients when using the ButterflyBVM™ and not simply squeeze when the device has reopened.
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