Bag Valve Mask: When to Use and How to Use It

Table of Contents:

1. Introduction
2. What is a Bag Valve Mask?
3. When to Use a Bag Valve Mask
4. Bag Valve Mask for Adults, Children, and Toddlers
5. Steps for Using a Bag Valve Mask
6. Common Mistakes to Avoid
7. Special Considerations
8. Wrapping Up

A bag valve mask (BVM) is a portable, hand-held device that is an important tool in emergency medical kits. It provides positive pressure ventilation to patients who are not breathing at all or not breathing adequately. This mask is commonly used by first responders, healthcare providers, and anyone trained in CPR to deliver oxygen to the lungs. Thus, whether you’re a healthcare professional, first responder, or someone interested in emergency preparedness, understanding when and how to use a Bag Valve Mask is crucial knowledge that could potentially save a life. 

Mastering the use of a BVM helps you respond confidently in emergencies. It ensures the person gets enough oxygen until professional medical help arrives. This article will delve into the specifics of this life-saving tool, exploring its applications and proper usage techniques.

 

What is a Bag Valve Mask?

A bag mask device is used to provide mechanical ventilation in cases where a patient’s breathing is insufficient or has stopped completely. It’s commonly used during CPR and other emergencies to keep oxygen flowing to the lungs. The BVM is easy to operate once you’ve been trained and is an important tool for anyone in the field of first aid or emergency care. Here’s a simple breakdown of its parts and types:

• Bag: The squeezable part that delivers air or oxygen into the patient’s lungs when compressed.
• Valve: This valve controls the flow of air and prevents air from flowing back into the bag, ensuring that only fresh air is pushed into the lungs.
• Mask: This mask fits securely over the patient’s mouth and nose to create a seal and allow air to be delivered effectively.

Types of BVMs:

Bag-valve masks come in various types, each designed for specific situations and patient needs. 

• Manual BVM: This type requires a person to squeeze the bag manually to deliver air into the patient’s lungs. It is the most common type used in first aid situations.
• Automatic BVM: This type of BVM uses a machine to control air delivery and is often seen in hospitals or advanced emergency settings.

Read More: Bag Valve Mask Technique In BLS

 

When to Use a Bag Valve Mask

A bag mask device provides a steady flow of air and prevents complications during cardiac arrest. This tool delivers oxygen and keeps the airways open until more advanced medical care arrives. Knowing when to use a BVM can help save lives in emergencies, especially during CPR. Here are the main situations when a BVM is needed:

• Respiratory Arrest: When a person has completely stopped breathing and needs assistance to get oxygen into their lungs, a bag mask is used to provide ventilation and support their respiratory function.
• Cardiac Arrest: During CPR, a BVM is used to provide breaths when the heart has stopped beating and the person is unresponsive.
• Severe Respiratory Distress: If someone is breathing very poorly (shallow or slow breaths) and needs help to maintain oxygen levels.
• Drowning: A BVM can help restore breathing in a person who has inhaled water and is struggling to breathe or has stopped breathing.
• Drug Overdose: When an overdose causes someone to stop breathing, a BVM can be used to provide breaths until the effects of the drug wear off or medical help arrives.

 

Bag Valve Mask for Adults, Children, and Toddlers

Proper use of a bag valve mask depends on the age and size of the person you’re helping. The technique for ventilating an adult is different from that for a child or toddler. It’s important to adjust the mask size, bag volume, and breathing rate to provide the right amount of air without causing harm. Here’s a quick guide to using a BVM for adults, children, and toddlers:

 

Age Group	Mask Size	Ventilation Rate	Bag Volume	Key Considerations
Adults	Large adult mask	1 breath every 5-6 seconds (10-12 breaths per minute)	1,000-1,500 mL	Ensure a tight seal over the nose and mouth; avoid over-ventilation to prevent lung injury.
Children	Pediatric mask	1 breath every 3-5 seconds (12-20 breaths per minute)	500-700 mL	Use a smaller mask and reduce the force of the squeeze to avoid delivering too much air. Watch for chest rise.
Toddlers/Infants	Infant mask	1 breath every 3-5 seconds (12-20 breaths per minute)	250-300 mL	Use the smallest mask and be extra gentle when squeezing the bag to prevent over-ventilation. Ensure the head is properly

Steps for Using a Bag Valve Mask

The bag valve mask CPR works to restore and maintain adequate circulation and breathing. Familiarity with the proper technique can save a life in an emergency, ensuring the patient gets the oxygen they need. Below are the key steps to follow when using a BVM.

1. Preparation:

To begin, ensure the Bag-Valve-Mask (BVM) device is properly prepared and functioning. Select the correct mask size based on whether the patient is an adult, child, or infant. Proper preparation is essential for effective ventilation during emergencies. Then, you have to position the patient on their back, tilt the head back, and lift the chin to open the airway.

2. Seal the Mask:

Securely seal the mask over the patient’s nose and mouth. Use the “E-C clamp” technique: Place your thumb and index finger around the mask while using the other fingers to lift the jaw. This helps ensure a snug fit, which is crucial for preventing air leaks and allowing proper ventilation. The bag-mask device tidal volume of 500 to 700 milliliters is important for achieving proper ventilation.

3. Deliver Breaths:

When delivering breaths, squeeze the bag gently and steadily, watching the patient’s chest to ensure it rises. For adults, give one breath every 5 to 6 seconds, and for children or infants, deliver one breath every 3 to 5 seconds. Be mindful not to over-inflate the lungs, especially with smaller patients.

4. Monitor the Patient:

You will have to continuously monitor the patient for visible chest rise, spontaneous breathing, or signs of consciousness. Based on the patient’s response, you can adjust the ventilation rate and depth to ensure adequate oxygenation without over ventilating.

5. Use Supplemental Oxygen (If available): 

If supplemental oxygen is available, connect it to the BVM device. This increases the concentration of oxygen delivered to the patient and improves the effectiveness of the breaths. This results in the enhanced recovery of the patient.

Read More: 10 Reasons why you should learn CPR

 

Common Mistakes to Avoid When Using A BVM

When using a bag valve mask (BVM), it’s easy to make mistakes that can reduce its effectiveness or cause harm to the patient. Being aware of these common errors can help you deliver safer, more effective care during an emergency.

• Ventilation: People must familiarize themselves with the answer to the question of what kind of ventilation a bag mask provides. This allows the rescuer to control the rate and volume of air delivered to the patient. 
• Inadequate Mask Seal: A poor seal between the mask and the patient’s face can lead to ineffective ventilation. Thus, rescuers should ensure the mask fits snugly and use the “E-C clamp” technique to maintain the seal.
• Over-ventilation: Squeezing the bag too forcefully or too frequently can cause air to enter the stomach (gastric inflation) or lead to lung injury. Always follow the correct ventilation rate and watch for chest rise.
• Improper Head Position: Improper head positioning can block the airway. Thus, tilting the head back and lifting the chin keeps the airway open, especially for unconscious patients.
• Ignoring the Chest Rise: Failing to observe the patient’s chest rise can mean that breaths are not being delivered properly. Always ensure the chest rises with each breath to confirm effective ventilation.
• Delaying Oxygen Connection: If supplemental oxygen is available, not connecting it promptly can reduce the effectiveness of the BVM. Attach the oxygen supply as soon as possible to deliver higher oxygen concentrations.

 

Special Considerations

Using a bag valve mask (BVM) can vary depending on the patient’s condition and the circumstances of the emergency. Being aware of special considerations can help you adjust your approach and ensure the best possible outcome.

• Use with Advanced Airways: When a patient has an advanced airway in place (such as an endotracheal tube), the BVM can still be used to provide ventilation. In this case, focus on delivering smaller, more controlled breaths to avoid over-inflation.
• Patients with Airway Obstructions: If the patient’s airway is partially blocked (due to an object, swelling, or trauma), delivering breaths might be challenging. Consider repositioning the head and using airway adjuncts like a nasal or oral airway to keep the airway open.
• Supplemental Oxygen: If oxygen is available, always connect it to the BVM. This increases the oxygen concentration delivered to the patient, which is especially important in cases of severe respiratory distress or cardiac arrest. 
• Trauma Patients: Avoid excessive head movement in patients with potential neck or spine injuries. In these cases, use the jaw-thrust technique instead of the head tilt or chin lift to open the airway while minimizing neck movement.
• Asthma or COPD Patients: Be cautious when ventilating patients with respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD). These patients are at risk of air trapping, so use smaller breaths and a slower ventilation rate.

 

Wrapping Up

Masks can drastically improve the rate of survival during CPR when used effectively. Hence, whether you’re a first aid responder or someone planning to take a CPR course, learning how to use a bag valve mask is a valuable skill that can improve your ability to respond confidently in emergencies. 

According to reports, people who are more confident using the BVM tend to deliver higher peak pressures and flow rates than those who are less confident. Training helps responders understand the correct volume of air for BVM, ensuring they provide the right amount of ventilation without overpressurizing the patient’s lungs.