As we are all aware, often the most difficult part of bagging a patient is maintaining a good seal. This can be complicated by facial hair, maxillofacial trauma, single user bagging, etc. The NuMask takes an innovative approach to solving these problems. Instead of putting the mask on the mouth, the NuMask slides in the mouth, not unlike a scuba mouthpiece. Doing so eliminates many of the complications associated with bagging.
The NuMask kit comes with two components. The first is an oropharyngeal airway similar to the oral airways most of us use save two big differences. First, it is made of a firm but pliable rubber rather than rigid plastic. Second, the airway has large grooves along either side to greater accommodate air movement. The second component to the NuMask is the intraoral mask. This is the component you connect to a bag just as you would a conventional mask. This is the element that separates the NuMask from a standard mask.
Here’s how it works. The intraoral mask is placed within the lips but above the teeth/gums. The seal is created not by pressing the mask against the face, but by wrapping the lips around the tube coming out of the mouth, keeping in mind that you must seal the nares as well lest your efforts escape right out from under the patient’s nose. During my usage of the device I found that the best way to create a seal was to wrap my hand around the tube portion of the mask and then pinch the nares with my thumb and forefinger while standing at the head of the bed. You then pull the lips up and around the tube to create a seal.
While use of the NuMask is more difficult in edentulous patients, it is still possible. The seal is made more difficult as the airway wants to slip into the oropharynx unless you are careful. Use of the oral airway in conjunction with the intraoral mask helps to prevent this. The NuMask setup also comes with a facial wrap that assists with holding the airway in place which I did not have the opportunity to test. The NuMask’s final result is a seal that, while a little cumbersome to establish, is much easier to maintain than a standard bag valve mask setup. When used in conjunction with the oral airway the NuMask provides very easy ventilation with little in the way of air leak. By my third use I found the NuMask as good if not better than conventional bag valve masking. While not without its problems the NuMask is a welcome alternative to conventional bag valve mask technique. I feel that this is especially true in single rescuer bagging. I see the NuMask as a useful tool in the ED, but I think that it will truly find its place in the EMS setting.
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