Perform the head-tilt-chin lift maneuver to open the victim's airway
Create a good mask-face seal by forming a C with your thumb and forefinger and using your other fingers, grasp the jaw, holding the mask firmly against the face.
In some patients, obtaining a seal may be difficult. An assistant may be needed to use two hands to obtain the seal.
Also consider the tidal volume being delivered. For both adults and children, tidal volume should be about 10 to 15 cc/kg. A 12 kg 1-year-old child should receive a tidal volume of 120 to 180 cc, while a 70 kg adult should receive a tidal volume of 700 to 1050 cc.
The rise and fall of the chest is an indication that the patient is being well ventilated.
You can use a bag-valve mask with an attached pressure monitor. These disposable devices are inexpensive and may be adapted to most Bag-valve masks. By knowing how much pressure is being created, this helps the user of bag-valve mask to deliver the correct tidal volume.
12 to 15 ventilations per minute is required in adults. When severe asthma, a rate of only 7 to 8 ventilations per minute may be indicated.
The Cricoid pressure (Sellick's maneuver) should be optional and may not prevent gastric insufflation and regurgitation.
Watch out for the degree of resistance felt when the lungs are ventilated. Decreased lung compliance is a result of asthma and lung contusion. When this happens, it may be necessary to use unusually large amounts of pressure.
A form of positive end expiratory pressure may also be administered with a Bag-valve mask by maintaining compression of the bag for about a second at the end of the victim's inspiration of air.
Important things to consider: