Ambu bag for manual ventilation

Ambu bag has been used in medicine for more than 50 years as an additional means during cardiopulmonary resuscitation. Modern models come in different volumes, are made from different materials and are equipped with additional accessories for the convenience of doctors and patients. This variety allows you to select a specific type of product based on the tasks and specifics of the medical institution.

The Zdravtorg company presents high-quality single-use and reusable Ambu breathing bags for children and adults produced by Apexmed International B.V. (Netherlands). These respiratory resuscitation devices are necessary when ventilation or oxygenation of the lungs is impaired due to respiratory failure or sudden respiratory arrest. It is also possible to use a bag for a constant supply of oxygen after connecting to a source of gas mixture.

Ambu type resuscitation breathing bags | Suggested Models

PVC Ambu bag (adult, disposable) 2350 rub.	PVC Ambu bag (children, disposable) 2350 rub.	PVC Ambu bag (neonatal, disposable) 2350 rub.
Ambu silicone bag (adult, reusable) 3350 rub.	Ambu silicone bag (children, reusable) 3350 rub.	Ambu silicone bag (neonatal, reusable) 3350 rub.

Proficiency in the technique of ventilating the lungs with an Ambu bag is included in the list of basic skills and abilities of doctors of all specialties, but it is most often used when providing emergency or first aid. Therefore, the breathing bag should be located in the following structural units: in the resuscitation and intensive care unit, in the emergency medical team layout, in operating rooms, in the maternity ward, in the surgeon’s office, in the medical outpatient clinic, at the duty post in any inpatient department.

Technically, ventilation is carried out according to the principle of a semi-open breathing circuit. This requires the constant active participation of a doctor or assistant, which consists of manual compression of the gas container. Immediately before starting ventilation of the lungs with an Ambu bag, the doctor should check its integrity and proper operation of the valves and, if necessary, connect a cylinder with a gas mixture. Then you need to make sure that the patient’s airway is open, and then press the breathing mask firmly to the face. Next, you need to compress the reservoir with the required frequency and monitor the effectiveness of ventilation based on chest movements and oxygen saturation of the blood. The reusable adult Ambu bag has a maximum ventilation resolution of 10 liters per minute, the children's version is 4 liters per minute.

As a medical product, the Ambu breathing resuscitation bag has a registration certificate from the Federal Service for Surveillance in Healthcare of the Russian Federation.

Ambu resuscitation breathing bag | Features and Benefits

• Available for children and adults (they differ in the size of the mask and the volume of the cylinder)
• Disposable models are made of PVC/SEBS, and reusable ones are made of high-strength medical hypoallergenic silicone
• Used for both continuous oxygen supply and auxiliary ventilation
• The components do not contain latex or other allergy-causing materials and substances.
• Instant control of the required volume of incoming oxygen
• Autonomous operation without the need for a network connection
• Silicone models can be autoclaved for up to 20 cycles
• Possibility of connecting a cylinder with a gas mixture
• No additional patient preparation required
• Convenient box for carrying and storage
• Quick replacement in case of breakdown

Ambu bag | Scope of delivery

• Breathing bag with pressure limiting valve - 1 pc.
• Tank bag - 1 pc.
• Oxygen hose 2 m - 1 pc.
• Face mask - 1 pc.
• Packaging - plastic box with handle

Manual breathing apparatus - Ambu bag | Specifications and prices

Name	Parameter
Ambu bag made of transparent implantation-non-toxic PVC, disposable	Adult	Children's	Neonatal
Breathing bag volume, ml
Reservoir bag volume, ml
Oxygen tube length, m
Sterilization and autoclaving	Not subject	Not subject	Not subject
Shelf life, years
Manufacturer	Apexmed, Netherlands	Apexmed, Netherlands	Apexmed, Netherlands
Ambu disposable PVC bag, price, rub.	2350	2350	2350
Ambu silicone bag, reusable	Adult	Children's	Neonatal
Breathing bag volume, ml
Reservoir bag volume, ml
Oxygen tube length, m
Structured bag surface
Swivel adapter with axis of rotation, degrees
Pressure limiting valve, cm H₂O
Plastic box with transparent lid and handle
Autoclaving, cycles
Shelf life, years
Manufacturer	Apexmed, Netherlands	Apexmed, Netherlands	Apexmed, Netherlands
Ambu reusable silicone bag, price, rub.	3350	3350	3350

How correctly and on the basis of what regulatory documents to process an Ambu-type resuscitative breathing bag, the box in which it is stored (it was included in the kit) and resuscitation masks?

Answer

on the purpose of the product (clause 2.3)

on the material and design features of the product specified by the manufacturer (clause 2.5, clause 2.16)

Depending on the purpose, after use the products are subject to:

• disinfection
• disinfection, PSO and sterilization.

Requirements for the full product processing cycle are given in clause 2.15:

“All medical products that come into contact with the wound surface, blood (in the patient’s body or injected into it) and/or injectable drugs, as well as certain types of medical instruments that during operation come into contact with the mucous membrane and can cause its damage, are subject to sterilization.

With regard to the processing of anesthesia-respiratory devices and removable parts for them, the requirements of clause 2.7 of SanPiN establish that their disinfection is carried out taking into account the recommendations set out in the operating manual for the device of a specific model (specific model of the product). Removable parts of devices are disinfected in the same way as medical products made from appropriate materials.

For each type of device and removable parts for it, the manufacturer indicates specific methods, methods and modes of processing. Unified methods, means and regimes for sterilization and disinfection of medical products were approved by order of the USSR Ministry of Health dated June 10, 1985 No. 770 and explained in the Guidelines dated December 30, 1998 No. 287-113.

Standards for the provision of information by the manufacturer of medical devices subject to reprocessing

Reusable breathing bags, breathing hoses, masks, as products that do not come into contact with the mucous membranes of patients, must be cleaned, disinfected, dried and stored after use and disconnection from the device under conditions that prevent secondary contamination.

Read for free in the Chief Nurse system:

ambu bag

Operating and resuscitation measures are directly related to supporting the patient's breathing. The ambu breathing bag helps resuscitators save lives. It provides artificial ventilation, has a simple algorithm and simple technology to use. If necessary, it can easily be used by persons without medical education.

What is an ambu bag

The device became a kind of breakthrough in medicine, so the name was firmly attached to all such devices (Figure 1).

Figure 1. External features of the device

The ambu breathing resuscitation bag is a great success, it is also known as:

1. Manual resuscitation system.
2. Pump for artificial ventilation of the lungs.
3. Breathing respiration mask.
4. Pulmonary resuscitation device.

It is a device consisting of a self-inflating balloon and a mask attached to it. Some of its models have the ability to dispense the breathing mixture.

Many manufacturers supplement the device with a backup kit of a different size. In this case, the ambu manual ventilation bag is universal - when resuscitating an adult or child, it is enough to simply replace the balloon. It is made from non-allergenic materials - when used repeatedly, the mask is treated with a disinfectant.

The ambu-type breathing bag is used by: ambulance crews, employees and rescuers of the Ministry of Emergency Situations, in intensive care units, anesthesiologists and resuscitators.

The main use of the ambu bag is situations related to respiratory dysfunction:

1. For patients who cannot breathe on their own.
2. In perinatology - in order to resuscitate newborns.
3. During clinical death or surgery until connected to an electrical ventilator.

The ambu bag ventilator comes in several types:

• disposable or reusable;
• for newborns and children whose body weight does not exceed 10 kg;
• pediatric - for those whose weight is between 10-40 kg;
• adult - for patients weighing more than 40 kg.

The principle of operation of an ambu bag

Despite its simplicity, the device is quite effective and reliable. An ambu resuscitation bag is used on the principle of manually squeezing a balloon from which air comes out. It is sent directly into the respiratory tract, and a mask through which oxygen passes is placed on the patient’s face (Figure 2).

Figure 2. Design and operating principle

The ambu breathing resuscitation bag allows you to saturate the lungs only if the airways are open, there are no obstacles in the form of vomit and foreign bodies, the tongue is stuck in the larynx and other causes of obstruction.

For connection to the respiratory tract, it comes complete with various adapters:

1. Tracheostomy or endotracheal tube.
2. Laryngeal or face mask with airway.
3. After joining them, the operator rhythmically squeezes the walls of the pouch.
4. The interval depends on the clinical situation - approximately 12-20 times per minute.
5. Operating temperature ranges from -18 to +50 degrees Celsius.

These additional devices have a standard hole diameter, allowing the device to connect to them as tightly as possible.

Disposable

In emergency situations and at outdoor events, one-time samples are used. The disposable silicone ambu bag is equipped with an anesthesia mask, oxygen and breathing bags, a gas inlet connector, air ducts and an oxygen tube, and a pressure limiting valve - optional.

Since the mouth-to-mouth breathing technique allows for the risk of infection with something, and the child’s lung capacity is smaller than that of an adult, an ambu bag for children, for newborns, implies only a single use, has the same characteristics in smaller sizes (Figure 3).

Figure 3. Disposable bags are used primarily for newborns.

It provides much greater ventilation efficiency, eliminates the need for sterilization and disinfection, and eliminates the risk of cross-contamination. In addition, his mask is made of polycarbonate, the bags and snorkel are made of polyvinyl chloride, and the air ducts are made of polypropylene. It cannot be reused.

Reusable

Can be found in every medical facility or ambulance. A reusable ambu bag is used when providing resuscitation care at the scene of an incident, in the cars of resuscitation teams when transporting patients and before connecting patients to an electronic ventilator (Figure 4).

The ambu bag mask is a reusable element, so it is subject to increased sterility and processing requirements.

At the same time, the reusable ambu bag itself is necessary exclusively for temporary ventilation, since it does not allow monitoring the volume of supplied air, does not have pressure control in the respiratory tract and requires constant manual participation in the process.

Figure 4. This is what reusable devices look like

The reusable ambu bag for adults differs from that for children:

1. Large volume of the cylinder and the need for disinfection.
2. Oxygen supply lines and filters, CO2 indicators can be connected to it.
3. Some options have ports for injecting special aerosols.
4. They can be used to relieve bronchospasms as a spacer.

Respiratory arrest can occur in a wide variety of situations, often during complex operations. Ventilation of the lungs with a hand-held ambu bag in such cases occurs before connecting a person to an electric ventilator and can save a human life due to simple mechanical action. In addition, it provides a simple and reliable supply of pure or oxygen-containing air and is included as standard equipment in intensive care units, intensive care wards and operating rooms (Figure 5).

Ventilating the lungs with an ambu bag is more hygienic compared to mouth-to-mouth breathing.

This is the simplest way to deliver air flow to the lungs, due to the simple design of the product. In essence, it is a small hand-held mechanical device, convenient for transportation when it is necessary to take emergency measures.

Figure 5. Principle of ventilation

Artificial ventilation of the lungs with an ambu bag is carried out as follows:

1. The mask is pressed to the victim’s face with the thumb and forefinger.
2. The middle and ring ones press on the corners of the lower jaw, throwing back his head.
3. With smooth, squeezing and quick movements of the fingers of the free hand, the air reservoir is compressed.
4. Air enters the lungs directly through the mask and exhales into the environment.

Ambu bag - instructions for use

Anyone can use the device, even if they do not have medical training (Figure 6).

A long time ago, back in 1953, German engineer and Dr. Holger Hesse, together with his partner (Danish anesthesiologist) Henning Ruben, were developing an innovative suction pump for technical needs. Then, succumbing to the excitement of research, they decided to adapt their creation for medical use. A few months of puffing over drawings and voila: scientists have developed the concept of the world's first hand-held portable device for artificial ventilation of the lungs.

According to their idea, it was supposed to be a special pump bag with valves, having a flexible mask for fixation on the patient’s respiratory tract. The doctors called their creation Ambu bag (). A few years later, in 1956, when the device was ready for production, they opened a company, naming it after the device (Ambu) and began selling their invention on the world market.

Since this was a real breakthrough for medicine at that time, and a product of this kind was presented to the general public for the first time, the name Ambu involuntarily became a household name. The name stuck and, despite the fact that almost 2/3 centuries have passed since then, Ambu still retains its influence. Nowadays, almost all resuscitation hand bags, no matter what brand or manufacturer, are called “Ambu bag” out of old “habit”.

What is an AMBU breathing bag?

The AMBU bag is a manual device for artificial ventilation of the lungs used for patients with breathing problems. In Russian medicine it is also called “pump for artificial ventilation of the lungs”, “manual pulmonary resuscitation bag”, “respiratory resuscitation bag”, “manual breathing apparatus”, etc. It is part of resuscitation ambulances, and is also used in intensive care and anesthesiology departments. The main purpose of the ambu bag is to allow the patient to breathe until the electrical ventilator is connected. The main advantage is that, compared to mouth-to-mouth artificial respiration, it is more hygienic, simple and effective (due to the absence of carbon dioxide, saliva particles and possible harmful microorganisms in the air entering the patient’s lungs).

What does an AMBU type bag consist of?

A full-fledged AMBU breathing bag consists of 7 parts: a mask, the main ventilation and reserve bags, a valve system and a nipple.

What is the operating principle of an ambu bag?

The principle of operation of the ambu bag is extremely simple: when the ventilation bag is compressed, air is “pushed” into the patient’s lungs, saturating the lungs with oxygen (while the non-reversible breathing valve prevents exhaled air from entering the bag back). Then the bag straightens out on its own, restoring its shape (air is sucked in from the valve located on the back of the bag). And so on ad infinitum, establishing a normal cycle of inhalation and exhalation. Both ambient air and a connected oxygen cylinder can be used as “fuel” (if the patient needs air with an increased amount of oxygen).

Evolution of the AMBU type bag

Almost seventy years have passed since the creation of the first ambu bag. New technologies have made it possible to make this useful invention lighter, more efficient, and more compact. The peak of achievements in the field of manual pulmonary resuscitation was folding ambu bags - special medical devices that can fold compactly and take up almost 5 times less volume than when unfolded.

The most famous and popular manufacturer of folding ambu bags at the moment is Micro BVM Systems Ltd.. Despite the fact that the company itself is registered in Israel (headquarters is in Jerusalem), the main owners (and at the same time consumers) are a group of US companies. Here the same situation is repeated as with - it is registered on some people, and the owners are on others.

However, this does not interfere with production at all - Micro BVM and Pocket BVM folding bags are used in many Western countries, covering half of Europe and O most of the US states. This was largely facilitated by the company NAR (North American Resque) - the Association of North American Rescuers (USA), actively promoting collapsible ambu bags in the military and paramilitary markets of America.

The most convenient (from the point of view of field medicine) folding ambu bags are their “tactical” version: a full-fledged (full-size, but folding) device for pulmonary resuscitation, compactly folded and packaged in a durable plastic case container that protects the contents from shock, dust, and dirt and the like. Due to their small size, such containers fit perfectly into a field first aid kit or a field medic's unloading pocket.

The most popular model today (06\2014) is the NAR Cyclone New & Improved Pocket BVM model, also called Cyclone Pocket BVM or “AMBU Bag - Cyclone Pocket BVM” in Russian. It is an improved model of the usual “pocket ambu bag” (Pocket BVM), in fact, being the “second generation” of collapsible resuscitation bags for ventilation.

Cyclone Pocket BVM is ready to use in just 3 easy movements and does not require specific medical knowledge or skills to use.

It is easy to use and can be deployed into working order in a matter of seconds, because... does not require “manual inflation” before use (it independently sucks in the air necessary to start ventilation).

To bring the NAR Cyclone Pocket BVM into working order, you need to perform four simple steps:
1) Detach the mask from the folded resuscitation bag and remove the device from the packaging container
2) Pull the end flaps in opposite directions, unfolding the bag
3) Tighten the front flap a little until it opens completely
4) Attach the mask back to the bag

The popularity of the Pocket Cyclone BVM is explained simply: the model is a full-fledged manual device for artificial ventilation of the lungs, having several times more compact dimensions than other ambu bags.
Thanks to manufacturing technology, Pocket Cyclone BVM is able to fold and shrink so compactly that the occupied volume is reduced by almost 5 times. And if, when assembled, its dimensions are similar to those of an American football ball...

When folded, the Pocket Cyclone BVM takes up almost as much space as a can of stew. Weighing 500 grams, the dimensions of the case are only 13.5*7.2 centimeters. According to statistics, this is 75% less in volume than other ambu bags.

In a word, we can say that the Cyclone Pocket BVM is one of the most compact and easy-to-use ambu bags today. It is designed for the same purposes as traditional ventilator pumps: Cyclone Pocket BVM is used for manual resuscitation and emergency ventilator support in patients who are not breathing or have difficulty breathing (respiratory failure).

Thanks to its ergonomic design, the Cyclone Pocket BVM is perfect for one-handed use. Its ventilation bag is designed in such a way that it requires only a small amount of force to compress and then quickly returns to its original shape. This helps reduce the fatigue of the physician, who is forced to “press the bulb” over and over again while ventilating the patient’s lungs. In addition, the surface of the Pocket Cyclone BVM vent bag has a textured design that prevents your hand from slipping and improves your grip.
The Cyclone BVM pocket comes with the following equipment: a hard carrying case (with a screw-on lid), a folding face mask, a folding ambu bag (a ventilation bag with a valve system), a reserve breathing bag, instructions (in English). Upon request, you can request the Russian version of the instructions (). Additionally (not in all trim levels) a two-meter oxygen tube is supplied (for supplying additional oxygen from a cylinder, when possible).

Manufacturer : North American Resque (NAR)\Micro BVM Systems Ltd.
Factory article number (manufacturer number according to USA catalogs): NSN#: 6515-01-568-0193
According to current US law, distributors are prohibited from shipping Pocket BVM products abroad, so purchasing it in Russia may be difficult. However, it has the necessary export permits for the export of folding ambu bags, so you can in the ““ section. There you can also find detailed technical specifications of the Pocket Cyclone BVM and its price.

The breathing apparatus, developed in 1956 by Danish professor-anesthesiologist Henning Ruben and German design engineer Holger Hesse to prevent widespread polio, is most often called the Ambu bag.

The inventors took as a basis their earlier development from 1953 - a suction pump for technical needs. They wanted to create a special pump bag, with valves and a flexible breathing mask that could be fixed on the patient's face. They called the new invention Ambu bag (Ambu bag or bag). Later, the company founded by Ruben and Hesse was named after the device.

Description

Since the invention was a real breakthrough in medicine and enjoyed incredible success, the name “Ambu bag” was assigned to all such devices. Also called:

• respiratory resuscitation bag, pulmonary resuscitation bag, breathing respiratory bag;
• manual resuscitation system;
• pump for artificial lung ventilation;
• manual breathing apparatus.

Not a single standard set of emergency resuscitation teams, intensive care and anesthesiology departments, or rescuers of the Ministry of Emergency Situations can do without it. Used to provide artificial respiratory support in patients who cannot breathe on their own. For example, in case of clinical death or during surgery until the patient is connected to an electric ventilator.

Can be disposable or reusable. Divided by type:

• for babies;
• children's;
• adult.

The disposable Ambu bag set includes:

1. Anesthetic mask.
2. Breathing bag.
3. Oxygen bag.
4. Oxygen tube.
5. Air ducts.
6. Gas inlet connector.
7. Pressure limiting valve (may or may not be present).

The mask is made of polycarbonate or polyvinyl chloride, the air ducts are made of polypropylene, and the tube is made of polyvinyl chloride. The temperature at which the device can be used ranges from -18 degrees to +50 degrees. It can be stored at temperatures from -40 to +60 degrees.

Operating principle

The mask is pressed tightly to the patient's face with the thumb and forefinger. At the same time, the middle and ring fingers press on the corners of the lower jaw, tilting the patient’s head back; – the fingers of the second hand begin to compress the air bag.

Squeezing movements should be smooth and fast. Through the mask, air begins to enter the lungs. Exhalation is made into the environment.

Very often, actions using an Ambu bag are compared to one of the types of artificial respiration - mouth to mouth. However, there is no risk of becoming infected with anything, and the effect is much greater.

Single use advantages:

• there is no threat of cross-contamination;
• there is no need for sterilization and disinfection.

Manufacturers

Many Chinese manufacturers are engaged in the production of resuscitation bags. Well-known global companies include Flexicare (UK) and Westmed (USA). Bags produced by Enter Medical Corp (Taiwan) are popular. In Russia, in particular, the Moscow company MITK-M is engaged in the production of resuscitation bags.

Disposal

According to the hazard class of medical waste, a disposable Ambu bag belongs to category B (that is, potentially dangerous) and after use must be packaged in a hermetically sealed, disposable, puncture-resistant yellow bag, specially marked. After the mandatory disinfection procedure, it is transported to a landfill or medical waste processing plant, where it can either be buried or burned.

Disposal of the Ambu bag occurs in accordance with SNiP No. 2.1.7.2790-10 dated February 17, 2011 “Rules for the collection, storage and disposal of waste from medical institutions.”