Bag mask ventilation: How do they deliver breaths? 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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 Share on Pinterestporpeller/Getty ImagesThe equipment used for BMV includes:self-inflating bagmask that covers a person’s nose and mouthoxygen sourceoxygen tubingpositive end-expiratory pressure (PEEP) valve, which helps maintain pressure in the lower airways during exhalationtubes 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 highhypoxic respiratory failure, which is a lack of oxygen in the bloodapnea, which is when a person stops breathingillness 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 breathrapid breathingfast heartbeatblue or purple skinrestlessnessheadachesconfusionaltered 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 airwaya tight seal on the face maskproper ventilation techniqueusing 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 obesityare older adultshave no teethhave beardsare snoringare 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. Last medically reviewed on September 16, 2022RespiratoryMedical Students / Training 6 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. 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.pdfBhutta, 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/nejmoa1812405Habrat, 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-ventilationLupton, 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.13927FEEDBACK:Medically reviewed by Jenneh Rishe, RN — By Anna Smith on September 16, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat to know about acute respiratory failure Symptoms of acute respiratory failure include shortness of breath and confusion. Potential causes include lung-related conditions and chest trauma…READ MOREWhat causes difficulty breathing?Medically reviewed by Gerhard Whitworth, RN People can experience difficulty breathing for a wide range of reasons. 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