How POM Stacks up Against Other Airway Management Choices
September 23, 2022
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Procedural Oxygen Masks (POM) are unique due to their self-healing membrane, higher FiO2 (fraction of inspired oxygen) delivery and capnography.
Other airway management choices available today include airway devices, bite blocks, masks that provide unwelcome positive pressure ventilation, and modified masks (clear oxygen masks with an access port cut in). Some masks are also specifically designed for endoscopy and fiberoptic intubation. These typically feature only a single oral access point and they can be used during bronchoscopy and transesophageal echocardiography. However, POM has self-healing membranes, which means it can also be used in recovery to ensure the patient continues to receive the prescribed amount of oxygen.
POM has a higher FiO2 delivery than other options. Depending on whether you insert a medium or high concentration adapter, POM can work as a medium or a high concentration mask. The medium concentration mask provides an average FiO2 of 80% with a flow rate of 8–10 liters per minute whereas the high concentration mask provides an FiO2 of more than 90%, with a suggested flow rate of 10–12 liters per minute (and a suggested upper limit of 15 liters per minute). This helps prevent hypoxia by reducing periods of desaturation and giving the physician more time to intervene. Traditional (and more expensive) ventilation masks and nasal cannulas only provide between 25% and 30% FiO2 delivery.
Crucially, POM allows clinicians to measure the exhalation of CO2, allowing them to tell immediately when the patient has stopped breathing. End tidal carbon dioxide (EtCO2) monitoring is the fastest method of ventilation and it allows interventions to occur in real time. POM has been found to outperform most free-flowing oxygen masks on the market for monitored anesthetic care (MAC) endoscopy.
Finally, POM also better protects medical staff from bacteria and bodily fluids when patients cough, making it particularly useful during the COVID-19 pandemic. During endoscopies, it’s very common for patients to cough, dispersing droplets around the clinic. Surgical masks already provide some protection but POM greatly reduces droplet dispersion and the spread of germs.