Which of the following complications is associated with the demand valve use?

• A. Pneumothorax
• B. All of the above
• C. Subcutaneous emphysema
• D. Gastric distention

Answer: (B)

Demand valve resuscitation can deliver air on inspiration, and if ventilation pressures are high or the seal is not optimal, air can be forced into unintended spaces. Pneumothorax occurs when overdistension vents air into the pleural space through ruptured alveoli. Subcutaneous emphysema can develop as air tracks from ruptured alveoli or the mediastinum into the subcutaneous tissues. Gastric distention happens when air is swallowed into the stomach, either from direct insufflation or excessive ventilation, which can lead to vomiting and aspiration risk. Because each of these complications can occur with demand valve use, all of the above is the best answer.