Bag and Mask Ventilation

To the Editor: The video and accompanying text by Ortega et al. on positive-pressure ventilation with a face mask and a bag-valve device (July 26 issue) 1 identify the tongue as the most common cause of airway obstruction. Although this concept is commonly accepted, it is probably inaccurate. Using plain radiographs, Safar et al. identified airway obstruction by the tongue and other soft tissues just above the laryngeal entrance in spontaneously breathing, anesthetized patients. 2 Obstruction of the nasopharynx by the soft palate was also noted. More recent studies suggest that the soft palate and epiglottis are actually the most common sources . . .