CPR Bag-Valve-Mask Ventilation: When & How to Use
Bag-valve-mask (BVM) ventilation is a core resuscitation skill.
Indications
- Apnea or inadequate breathing in cardiac arrest/respiratory failure.
- Pre-oxygenation before intubation.
- During CPR when advanced airway not yet placed.
Key Points
- Two-person technique preferred: One seals mask (E-C clamp), other squeezes bag.
- Tidal volume: ~500–600 mL (chest rise only); avoid overventilation.
- Rate: 10 breaths/min (adult cardiac arrest with advanced airway); 30:2 compression:ventilation without advanced airway.
- Oxygen: Attach reservoir + high-flow O2 (15 L/min) for near-100% FiO2.
- Gastric inflation risk: Cricoid pressure (controversial), avoid excessive volume/pressure.
Training
BVM requires practice. Lay rescuers: focus on compressions; rescue breaths if trained. Healthcare providers: maintain BVM proficiency.
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