Skip to main content

Bag-Valve Mask

THIS PROCEDURE APPLIES TO: Any patient unable to adequately ventilate him/herself who needs supplemental oxygen delivered via a bag-valve mask.

EXCLUSION CRITERIA: None

AUTHORIZATION: All Levels

PROCEDURE

  1. Observe body substance isolation precautions.
  2. Rescuer 1 should position him/herself at the top of the victim’s head. Rescuer 2 should kneel at the patient’s side.
  3. Open the patient’s airway and maintain it with an oropharyngeal airway.
  4. Because bag-valve masks are most effective when used by at least two rescuers working together, when two rescuers are available the bag-valve mask will be a two-person skill.
  5. When two persons use the bag-valve mask:
    1. Rescuer 1, using both hands, positions the mask to maintain a seal around the nose and mouth.
    2. Rescuer 2 squeezes the bag with both hands, delivering each breath over 2 seconds.
    3. Apply cricoid pressure throughout the entire procedure or until the patient is successfully intubated.
  6. If only one rescuer is available:
    1. With one hand, apply the mask to the patient’s face.
    2. Grip the mandible with the last two or three fingers while gripping the mask with the remaining fingers.
    3. Maintain head tilt and jaw lift while maintaining a seal around the nose and mouth.
    4. Compress the bag with the other hand while observing the chest to ensure chest rise.
    5. Connect the bag-valve mask to an oxygen source.

Ventilating the Conscious Patient

  1. To avoid resistance or combativeness due to fear, explain the procedure to the patient.
  2. Begin by matching the volume and rate of the patient’s ineffective breathing. Adjust the rate and volume until you are ventilating at the necessary rate and volume.

Ventilating During CPR

  1. Administer each ventilation over one second, regardless of the patient’s size or age.
  2. Each ventilation should be of sufficient volume to make the patient’s chest rise.
  3. Ventilations administered during CPR increase pressure in the chest. This pressure reduces the amount of blood that refills the heart and in turn reduces the blood flow generated by the next set of chest compressions. For these reasons, ventilating too frequently or with too large a volume (hyperventilating) may be harmful because it may reduce blood flow generated by chest compressions.

Back to top