What does MOANS stand for in assessing difficult BVM seal?

• A. M-mask seal due to facial hair, anatomy, blood or secretions/trauma; O-obese or late pregnancy; A-age >55; N-no teeth; S-stiff or increased airway pressure
• B. M-mask seal; O-obese; A-allergy; N-nasal obstruction; S-sedation
• C. M-mouth opening; O-obstruction; A-age; N-neck mobility; S-sneezing
• D. M-movement; O-oxygen; A-airway; N-nose; S-sleep apnea

Answer: (A)

MOANS identifies factors that make achieving a good mask seal during bag-valve-mask ventilation difficult.

M stands for issues with the mask seal caused by facial hair, facial anatomy, blood or secretions, or facial trauma that disrupts the seal. O stands for obesity or late pregnancy, both of which alter facial structure and chest mechanics and complicate seal and ventilation. A is for age over 55, reflecting age-related changes that can affect dentition and tissue elasticity and thus seal. N denotes no teeth, which changes how the mask sits on the jaw and face to maintain a seal. S represents stiffness of the chest or increased airway pressure that makes it hard to maintain a reliable seal while delivering breaths.

These are the classic cues to anticipate a difficult BVM seal and guide you toward appropriate adjustments or alternative airway strategies. Other options include factors like allergy, nasal obstruction, or sedation, which aren’t part of this mnemonic and don’t specifically describe issues with achieving a mask seal.