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Skill 20: Bag-valve-mask ventilation

Task: Oxygenate and ventilate using the bag-valve-mask correctly & safely
on a manikin
Criteria for satisfactory completion of task : when all relevant aspects of the
task: governed by the following principles are demonstrated
adequate preparation of the patient and tools for the procedure
conduct of the procedure adheres strictly to principles of asepsis and standard
consideration of patient safety and comfort
adequate documentation of the procedure
recognition of limitations and possible complications

Expected Actions

gathers equipment (MALES)
M masks, monitor
A airway, assistant
L laryngoscopes, line, LMA
E endotracheal tube
S suction, stylet
standard precautions

Ensure that all components of the bag-valve unit are present

- Self-inflating bag
- Reservoir bag
- Patient valve
- Reservoir flap valve
- Oxygen tubing connected to an oxygen source once available

TS/RL 2013

Ensure that all the valves are in proper function

1. Intake valve
- Compress the self-inflating bag. Rapid re-expansion confirms efficient air
- Block the patient valve and try to compress the bag. If the bag cannot be
compressed, the valve is efficiently preventing backward escape of air
2. Patients valve
a) Lip valve
- Place the reservoir bag over the patients valve. Compress the selfinflating bag several times. This will fill the reservoir bag and confirm that
the patient valve is able to efficiently direct air to the patient
b) expiratory port = disc membrane
- Compresses the filled reservoir bag. The lifting of the disc membrane
confirm that air from the ventilation bag has been vent to the atmosphere
3. Reservoir flap valve
a) overpressure relief valve
- Fills the reservoir bag with air again (follow step 2a). Quickly attached the
filed reservoir bag to the reservoir flap valves. Now compress the reservoir
bag. Lifting of the overpressure valve confirms the venting of air from the
reservoir bag to the atmosphere.
b) air entrainment valve
- Connect the reservoir bag to the reservoir flap valves. Compress the selfinflating bag. Rapid re-expansion of the self-inflating bag confirms intake of
air through the air entrainment valve

Assemble the bag valve unit

Choose the appropriate mask size

- mask should fit from the nasal bridge till just above the chin and covers
the lips completely
- mask should not be pressed on the manikins eyes

TS/RL 2013

Provide effective ventilation by ensuring:- misting in the mask

- visible chest rise
- no air leak around the mask

Without CPR
- deliver 1 ventilation every 5 6 seconds (one breath every 10-12
With CPR
- at a compression : ventilation ratio of 30:2

TS/RL 2013