Using a Handheld Resuscitation Bag and Mask

Goal: The patient exhibits signs and symptoms of adequate oxygen saturation.

1. If not a crisis situation, perform hand hygiene.

2. Put on PPE, as indicated.

3. If not an emergency, identify the patient.

4. Explain what you are going to do and the reason for doing it to the patient, even if the patient does not appear to be alert.

5. Put on disposable gloves. Put on face shield or goggles and mask.

6. Ensure that the mask is connected to the bag device, the oxygen tubing is connected to the oxygen source, and the oxygen is turned on, at a flow rate of 10 to 15 L per minute. This may be done through visualization or by listening to the open end of the reservoir or tail: if air is heard flowing, the oxygen is attached and on.

7. If possible, get behind head of bed and remove headboard. Slightly hyperextend patient’s neck (unless contraindicated). If unable to hyperextend, use jaw thrust maneuver to open airway.

8. Place mask over patient’s face with opening over oral cavity. If mask is teardrop-shaped, the narrow portion should be placed over the bridge of the nose.

9. With dominant hand, place three fingers on the mandible, keeping head slightly hyperextended. Place thumb and one finger in C position around the mask, pressing hard enough to form a seal around the patient’s face.

10. Using nondominant hand, gently and slowly (over 2 to 3 seconds) squeeze the bag, watching chest for symmetric rise. If two people are available, one person should maintain a seal on the mask with two hands while the other squeezes the bag to deliver the ventilation and oxygenation.

11. Deliver the breaths with the patient’s own inspiratory effort, if present. Avoid delivering breaths when the patient exhales. Deliver one breath every 5 seconds, if patient’s own respiratory drive is absent. Continue delivering breaths until patient’s drive returns or until patient is intubated and attached to mechanical ventilation.

12. Dispose of equipment appropriately.

13. Remove face shield or goggles and mask. Remove gloves and additional PPE, if used. Perform hand hygiene.