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