When it comes to dealing with medical emergencies in the dental office, many dentists have positive pressure demand valves, such as the one pictured below, to administer ventilations to a patient during a medical emergency. In fact, some companies are still supplying these demand valves to dental offices. However, positive pressure demand valves have fallen out of favor within the medical community for several reasons. First, during the intense and stressful moments of a medical emergency, the rescuer frequently has a tendency to hyperventilate the patient, not allowing the patient to exhale completely. By repeatedly giving breaths to a patient without allowing full exhalation, the breaths become stacked, one on top of the other. With the use of a positive pressure demand valve this can lead to baro-trauma and subsequent pneumothorax. Secondly, by using a positive pressure demand valve to deliver breaths, the rescuer has no way to judge how much oxygen has been given with each push of the button, or whether the ventilations are effective. Finally, after sitting in a closet for years, the springs become weak and the gaskets dry out rendering the demand valve useless when needed.
Twenty years ago, positive pressure demand valves were commonly found in ambulances and emergency r
ooms throughout the country. However, in California at least, positive pressure demand valves are no longer used in emergency medicine or onboard any ambulance. Instead, the American Heart Association recommends the use of a Bag Valve Mask or BVM. The BVM has become the standard of care when providing ventilatory support. All health care providers, including dentists, hygienists, and dental assistants must maintain current certification in Basic Life Support for the Health Care Provider. The proper use of a BVM is one of the core topics taught in this class through the American Heart Association.
If you currently have a positive pressure demand valve in your office, consider replacing the positive pressure regulator with a flow regulator, and purchase a disposable bag valve mask. The total cost for this is around $100, and it is a cheap price to pay to provide proper care for your patients.
Positive Pressure Demand Valve
Bag Valve Mask
