This was an attempt of a non rebreather mask, made by the st | Figure 1

This was an attempt of a non rebreather mask, made by the staff at a SNF for a patient with orders for a NRB @ 15LPM. The materials used?

  1. Humidification drain bag.
  2. Zip tie.
  3. Aerosol mask.
  4. O2 bleed in adaptor.

When I walked in, the patient had Saturations of 78% on 8lpm.

Why you should join Figure 1

Laryngeal mask airway surfactant administration for prevention of morbidity and mortality in preterm infants with, or at risk of, respiratory distress syndrome

Key messages

What did we want to find out? We wanted to find out if surfactant administration via laryngeal mask airway compared to placebo, no treatment, or surfactant administration via an endotracheal tube or other less‐invasive methods given to premature infants with or at risk of respiratory distress syndrome could improve survival. We also wanted to know if it reduced the risk of developing a chronic lung condition called bronchopulmonary dysplasia (BPD) or duration of mechanical ventilation and other outcomes, such as any harmful effects.

What did we do? We searched for studies that compared surfactant administration via laryngeal mask to no treatment, surfactant administration via an endotracheal tube or other less‐invasive methods in preterm infants with or at risk of respiratory distress syndrome.

What did we find? We identified eight studies that investigated this therapy in 510 premature infants. Surfactant administration via laryngeal mask may reduce the need for mechanical ventilation at any time when compared to surfactant administration via endotracheal tube. Furthermore, we found that surfactant administration via laryngeal mask probably reduces the need for mechanical ventilation at any time compared to no surfactant administration. Long‐term outcomes were not reported. No trial compared surfactant administered by laryngeal mask airway to surfactant administered by a thin catheter. Given the encouraging results from these trials, high‐quality trials of laryngeal mask airway surfactant administration in very preterm infants with or at risk of respiratory distress syndrome are justified.

What are the limitations of the evidence? We are not confident in the evidence because it was based on relatively few cases and few studies.

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Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in the family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?