Previous article Table of Contents  Next article

LETTER TO EDITOR
Year : 2011  |  Volume : 5  |  Issue : 2  |  Page : 237-238

Easy way of improving seal with Rendell-Baker-Soucek mask: Old equipment revisited


1 Department of Anaesthesia & Intensive Care, Alchemist Hospitals Ltd., Panchkula, Haryana, India
2 Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Amit Jain
Department of Anaesthesia & Intensive Care, Alchemist Hospitals Ltd., Panchkula, Haryana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.82823

Rights and Permissions
Date of Web Publication7-Jul-2011
 


How to cite this article:
Jain A, Makkar JK, Batra Y K. Easy way of improving seal with Rendell-Baker-Soucek mask: Old equipment revisited. Saudi J Anaesth 2011;5:237-8

How to cite this URL:
Jain A, Makkar JK, Batra Y K. Easy way of improving seal with Rendell-Baker-Soucek mask: Old equipment revisited. Saudi J Anaesth [serial online] 2011 [cited 2019 Feb 17];5:237-8. Available from: http://www.saudija.org/text.asp?2011/5/2/237/82823

Sir,

Rendell-Baker-Soucek (RBS) face mask has been used for mask ventilation in pediatric patients. It reduces dead space to a quarter of anatomical facemasks with inflatable pad but has the disadvantage of not providing padded seal.[1],[2],[3] This make the use of RBS face mask inadequate in cases where mask holding is difficult, especially when the anesthesiologist has had limited experience with the pediatric airway. At times, it is not possible to obtain adequate seal even with two-hand technique. Further, when the duration of anesthesia is brief or endotracheal intubation is planned, the issue of dead space seems less important than the ability to deliver positive pressure ventilation. As a result, a very few centers now use these masks. However, a simple modification in the RBS mask could improve its seal in difficult situations. We report three cases wherein difficult mask ventilation was encountered and managed successfully with the modified RBS face mask.

Case 1: A 5-year-old malnourished male child with shrunken cheeks was posted for unilateral pyeloplasty. Even with two-hand technique, size 2 RBS mask failed to provide an adequate seal for adequate positive pressure ventilation after induction of anesthesia.

Case 2: A 6-year-old male patient developed laryngospasm following removal of laryngeal mask airway at the end of hernia repair. Continuous positive airway pressure (CPAP) was applied in an attempt to treat laryngospasm and maintain oxygenation. Size 2 RBS face mask, though used successfully to ventilate the lungs at induction, failed to provide an effective seal during CPAP therapy.

Case 3: A female patient of age 5 years and 6 months with empyema was posted for decortication surgery. Adequate ventilation could not be provided with size 2 RBS mask due to poor compliance and inadequate seal between the face and the mask. This resulted in rapid desaturation.

An alternate means of obtaining seal in these cases was by mounting/applying foam pad of head phone over the perimeter of the face mask [Figure 1]. This improved the seal and adequate mask ventilation was obtained without difficulty, even with one-hand technique. Further, the effective dead space of the equipment was not increased as the body of the detachable foam pad mainly fell within the cavity of the face mask [Figure 2], especially when pressure was applied in an attempt to obtain tight seal between mask and face. Thus, this modification to the RBS mask retains the benefits of low profile of the mask while providing foam pad to it. We recommend that a preformed detachable foam pad according to the size of respective RBS face mask can be provided by the manufacturer, to be used in case of difficult seal and mask ventilation.
Figure 1: RBS face mask and foam pad of head phone. Arrow points the groove in the foam pad where margins of the mask fit

Click here to view
Figure 2: RBS mask with arrow showing foam pad falling within cavity of face mask

Click here to view


 
  References Top

1.Rendell-Baker L, Soucek DH. New pediatric face masks and anaesthetic equipment. Br Med J 1962;1:1690.  Back to cited text no. 1
    
2.Palme C, Nystrom B, Tunell R. An evaluation of efficiency of face masks in the resuscitation of new born infants. Lancet 1985;1:207-10.   Back to cited text no. 2
    
3.Clarek AD. Potential deadspace in an anaesthetic mask and connectors. Br J Anaesth 1958;30:176-81.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

Top
 
Previous article    Next article
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  IN THIS Article
   References
   Article Figures

 Article Access Statistics
    Viewed1570    
    Printed144    
    Emailed0    
    PDF Downloaded79    
    Comments [Add]    

Recommend this journal