Saudi Journal of Anaesthesia

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


Amit Jain1, Jeetinder Kaur Makkar2, YK Batra2,  
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




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;5:237-238


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 2020 Oct 22 ];5:237-238
Available from: https://www.saudija.org/text.asp?2011/5/2/237/82823


Full Text

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}{Figure 2}

References

1Rendell-Baker L, Soucek DH. New pediatric face masks and anaesthetic equipment. Br Med J 1962;1:1690.
2Palme C, Nystrom B, Tunell R. An evaluation of efficiency of face masks in the resuscitation of new born infants. Lancet 1985;1:207-10.
3Clarek AD. Potential deadspace in an anaesthetic mask and connectors. Br J Anaesth 1958;30:176-81.