What should be done if a COPD or Asthma patient develops poor bag compliance during positive pressure ventilations?

When a COPD or asthma patient exhibits poor bag compliance during positive pressure ventilation, it is essential to allow for complete exhalation as part of managing their respiratory distress effectively. These conditions can lead to issues with airflow, causing air trapping and difficulty in ventilating them properly.

By discontinuing positive pressure ventilations for a brief period, you allow the patient to exhale fully. This can help to alleviate the build-up of air in the lungs, facilitating better compliance when you resume positive pressure ventilation. It can also provide a moment for the patient's lungs to reset, making it easier to deliver oxygen without excessive pressure or causing discomfort.

In this context, simply increasing pressure settings or switching to manual ventilation may not address the underlying issue of trapped air, and administering oxygen alone does not resolve the issue of poor compliance during bag ventilation. Allowing for complete exhalation is a strategic approach to ensure that subsequent ventilations are effective and to minimize the risk of further lung inflation issues.