View source for Bag valve mask ventilation

==Overview==
*Simple, life-saving skill that is critical in airway management
*Deliver oxygen at positive pressure via a bag containing oxygen connected to a mask placed over a patient's nose and mouth
*Oxygenation and ventilation prior to definitive airway placement or bridge to sedative metabolization

==Indications==
*[[Respiratory failure]]
*Pre-oxygenation
*Emergent need to oxygenate/ventilate

==Contraindications==
No absolute contraindications
{{Difficult BVM}}

==Equipment Needed==
*Bag connected to oxygen at 15L/min
*Mask connected to the bag
*Consider PEEP valve (provides PEEP between ventilations)
*[[OPA]]/NPA/adjuncts to facilitate successful BVM ventilation
*Suction
*SpO2 monitor helpful
====Children====
*Proper-sized mask (covers nose and chin)
*Proper bag (enough to see chest rise)

==Procedure==
==="EC" Hand Position===
*Thumb and index finger holding mask in a "C" position
**Thumb superior and index inferior
*3rd, 4th, 5th finger hold the mandible and perform a jaw thrust 
*Other hand used to bag
===2-person===
*One person holds the mask with both hands (lateral edges)
**With double EC technique, index fingers and thumbs of both hands form C over mask and digits 3-5 lift the jaw at the rami of mandible
**Can also press thumbs and thenar eminences over lateral edges of mask and use digits 2-5 to lift jaw at the rami of the mandible
**Important to life jaw into mask and not press mask down into jaw; can occlude the airway and cause difficulty with ventilation
*2nd person bags

===Rate===
*Adult bag at 10-12/min 
*Children 16-20/min
*Infants 30/min
*Neonates 40-60/min

===Tidal Volume===
*Avoid hyperinflation
**Average bag volume is approximately 1600 cc; only necessary to delivery approximately 500 cc
*Bag until chest rise is seen

==Complications==
*Poor seal
**Remove dentures to intubate; keep them in to bag/mask ventilate
**For a beard can smear lube to help create better seal
*Poor oxygenation/ventilation
**Readjust head-tilt-chin-lift or jaw thrust
**Utilize [[oropharyngeal airway]]/[[nasopharyngeal airway]]
*Overinflation of the stomach causing emesis/aspiration

==See Also==
*[[Intubation]]
*[[Oropharyngeal airway]]

==External Links==

==References==
<references/>

[[Category:Procedures]]
[[Category:Critical Care]]
[[Category:EMS]]