Question

A baby is born at term with a bilateral cleft lip and palate and a very small mandible. she requires positive-pressure ventilation because she is not breathing. you are unable to achieve a seal with bag and mask. which intervention is indicated?

Answer 1

The right answer is to insert a laryngial mask

The laryngeal mask is a material intended for the ventilation of patient in anesthesia. Its indication includes short-term interventions (less than two hours) without modification of the operative position and allowing immediate access to the head in order to achieve a traditional intubation if the need arises. The patient must be fasting and present no risk of inhalation.

Answer 2

In infants with cleft lip and palate, nasal mask is not possible since air leakage will happen through the cleft defect. A modified positive airway pressure must be applied, then, to save the baby. A suctioning may be required, but one must be careful enough when inserting the catheter into the mouth. Putting a cardiac monitor and pulse oximeter helps to check the baby’s condition.