Bag-Mask Ventilation

Airway · Anesthesia/Emergency · Continuous until definitive airway

Positive-pressure ventilation using a self-inflating bag and mask to oxygenate an apneic or hypoventilating patient.

Indications

  • • Apnea
  • • Hypoventilation
  • • Pre-oxygenation before intubation
  • • Cardiac arrest

Contraindications

  • ⚠ Complete upper airway obstruction (relative)
  • ⚠ Severe facial trauma (relative)

Equipment

  • • Self-inflating bag with reservoir
  • • Appropriately sized mask
  • • O2 source at 15 L/min
  • • OPA/NPA
  • • Suction ready

Positioning

  • • Sniffing position; head tilt–chin lift (or jaw thrust if C-spine concern).

Consent

  • • Explain indication, benefits, alternatives
  • • Explain risks & complications
  • • Obtain written/verbal consent as per SOP
  • • Document consent

Universal precautions

  • • Hand hygiene
  • • PPE — gloves, mask, eye protection
  • • Aseptic technique
  • • Sharps safety
  • • Verify patient identity & site

Step-by-step (0/5)

Tap to complete

Head tilt–chin lift or jaw thrust; insert OPA if no gag.

Why: Prevents tongue obstruction

Pearl: Two-person BMV improves seal

Immediate complications

  • ⚠ Gastric insufflation
  • ⚠ Aspiration
  • ⚠ Barotrauma
  • ⚠ Inadequate ventilation

Delayed complications

  • • Pneumonia

Recognition

  • • Poor chest rise
  • • Falling SpO2
  • • Gastric distension

Initial management

  • • Reposition airway
  • • Add OPA/NPA
  • • Two-person technique
  • • Reduce tidal volume

Prevention

  • • Correct mask size
  • • Slow controlled breaths

Post-procedure observation

  • • Vitals q15min × 1h then hourly

Monitoring

  • • Site inspection
  • • Symptom review

Documentation

  • • Procedure note
  • • Consent
  • • Findings

Patient instructions

  • • Report pain, bleeding, fever, worsening symptoms

Related in WardRound

Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.

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Clinical Decisions in Seconds