Bag Mask Ventilation: How Do They Deliver Breaths?

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Medical News TodaySubscribeHuman BiologyHow does using a bag mask device deliver breaths?

Medically reviewed by Jenneh Rishe, RN — Written by Anna Smith Haghighi on September 16, 2022

How they work
Instructions
Purpose
Effectiveness
Risks
Summary

Bag mask ventilation (BMV) is a method for providing a person with immediate ventilation in an emergency. BMV involves a medical professional manually pumping oxygen into a person’s lungs using a self-inflating bag to simulate breathing.

Certain health conditions and accidents can cause a person to have breathing difficulties. BMV uses bag valve masks, or Ambu bags, to supply a person with oxygen.

A bag valve mask is a handheld tool that a medical professional can use to pump oxygen into a person’s lungs.

This article details BMV, including how it works, step-by-step instructions, effectiveness, and possible risks.

How do they work?

A bag mask device to deliver breaths. — porpeller/Getty Images

The equipment used for BMV includes:

self-inflating bag
mask that covers a person’s nose and mouth
oxygen source
oxygen tubing
positive end-expiratory pressure (PEEP) valve, which helps maintain pressure in the lower airways during exhalation
tubes to hold the airways open

The self-inflating bag is attached to a valve and then to a soft face mask. The other end of the self-inflating bag is attached to a tank containing 100% oxygen.

A medical professional then places the face mask over a person’s nose and mouth, then manually squeezes the self-inflating bag. Squeezing the bag pushes oxygen into the person’s lungs, which replicates the action of breathing.

A medical professional can attach a PEEP valve to the bag valve mask to help maintain pressure inside the lungs. This can help prevent damage to the delicate sacs of air on the lungs, called alveoli.

Step-by-step instructions

A medical professional will perform the following steps:

Stand behind the person and tilt their chin slightly upward to open their airway.
Insert a tube into the person’s mouth to prevent the tongue from covering the airway. They may insert a tube into the nose if the throat is blocked.
Place the mask over the person’s nose and mouth, and apply pressure to the mask with one hand to keep the seal tight.
Before attaching the oxygen, squeeze the self-inflating bag, allowing air to flow into the person’s lungs. Empty the entire bag over 1⁠–2 seconds and then release it. Releasing the bag allows it to refill.
Continue providing ventilation for 30 seconds before attaching the oxygen tank.
Attach the oxygen, and supply the person with 15 liters of oxygen per minute.

If there are two medical professionals, one will hold the mask in place while the other squeezes the self-inflating bag.

The method is the same in adults and children. However, they will use smaller bag valve masks for children.

When are they needed?

Medical professionals use BMV in emergencies to provide a rapid supply of oxygen. A person may need assistance breathing if they are experiencing:

hypercapnic respiratory failure, which causes carbon dioxide levels to be too high
hypoxic respiratory failure, which is a lack of oxygen in the blood
apnea, which is when a person stops breathing
illness that affects their airway

Some people may also require BMV before certain scheduled surgeries.

Without an adequate amount of oxygen, a person can develop hypoxia. Hypoxia is a condition where a person does not have enough oxygen in their body tissues.

It can be mild or severe, causing symptoms such as:

shortness of breath
rapid breathing
fast heartbeat
blue or purple skin
restlessness
headaches
confusion
altered mental activity

Hypoxia can also lead to coma or death.

Are they always successful?

Research suggests that BMV can be a successful ventilation technique when used correctly.

A study from 2020 found that bag valve mask-only ventilation was associated with improved cardiac arrest episodes that occurred outside a hospital.

Additionally, research from 2019 found that critically ill people receiving BMV alongside tracheal intubation had higher oxygen saturation levels and lower rates of severely low oxygen levels.

Affecting factors

The success of BMV ventilation can depend on certain factors, such as:

the person’s airway
a tight seal on the face mask
proper ventilation technique
using a PEEP value when required

A medical professional must ensure that a person is in the correct position before beginning BMV. Certain factors can make BMV more difficult for a healthcare professional.

These factors include people who:

have obesity
are older adults
have no teeth
have beards
are snoring
are stiff

Risks

Certain complications can occur due to BMV. If the technique inflates the lungs too much, they can become damaged.

BMV can lead to air entering the stomach if used incorrectly or for long periods. This can cause a person’s stomach to swell or lead to vomiting.

Vomiting while being ventilated can be dangerous. If a person breathes in their vomit, it can lead to infections such as pneumonia or choking.

Summary

BMV is a technique used to ventilate a person in an emergency. It involves a healthcare professional manually pumping oxygen into a person’s lungs using a bag valve mask.

Certain factors can cause BMV to become more difficult, such as a person’s age. However, if done correctly, BMV can be a successful ventilation method.

BMV can cause certain complications if performed incorrectly. This includes lung damage and vomit aspiration.

Respiratory
Medical Students / Training

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bag-valve-mask ventilation. (2019).https://www.health.ny.gov/professionals/ems/pdf/srgpsbvm.pdf
Bhutta, B. S., et al. (2022). Hypoxia.https://www.ncbi.nlm.nih.gov/books/NBK482316/
Bucher, J. T., et al. (2022). Bag mask ventilation.https://www.ncbi.nlm.nih.gov/books/NBK441924/
Casey, J. D., et al. (2019). Bag-mask ventilation during tracheal intubation of critically ill adults.https://www.nejm.org/doi/full/10.1056/nejmoa1812405
Habrat, D. (2022). How to do bag-valve-mask (BVM) ventilation.https://www.msdmanuals.com/en-gb/professional/critical-care-medicine/how-to-do-basic-airway-procedures/how-to-do-bag-valve-mask-bvm-ventilation
Lupton, J. R., et al. (2020). Outcomes with the use of bag–valve–mask ventilation during out-of-hospital cardiac arrest in the pragmatic airway resuscitation trial.https://onlinelibrary.wiley.com/doi/10.1111/acem.13927

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Medically reviewed by Jenneh Rishe, RN — Written by Anna Smith Haghighi on September 16, 2022

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Tag » How Are Breaths Delivered With Bag Mask

Bag Mask Ventilation: How Do They Deliver Breaths?

How do they work?

Step-by-step instructions

When are they needed?

Are they always successful?

Affecting factors

Risks

Summary

How we reviewed this article:

Latest news

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