Emergencies and resuscitation

How to ventilate with a bag-valve mask

Other platforms explain it with text and video. In VMS you practice it on the patient.

EMS (NREMT)Nursing (NCLEX)MD / DO

Bag-valve-mask ventilation is the airway skill that saves the most lives in an emergency. The hard part is the seal, so two rescuers work better than one.

What you need

Step by step

  1. Protect yourself and open the airway

    Gloves on. Head tilt and chin lift, or jaw thrust only if a spine injury is possible. [1]

  2. Clear and size an airway

    Suction if needed. Size an oral airway from the corner of the mouth to the angle of the jaw and insert it if there is no gag reflex. [1]

  3. Connect oxygen

    Oxygen at 15 L/min with the reservoir attached and filling. [1]

  4. Seal the mask

    Right mask size over nose and mouth. One hand in an E-C clamp: thumb and index finger press the mask, other fingers lift the jaw into the mask. With two rescuers, one holds the seal with both hands and the other squeezes. [1]

  5. Ventilate

    Squeeze over about one second, just enough to see the chest rise. For an adult with a pulse, one breath every 6 seconds. [2]

  6. Check it works

    Chest rises and falls, saturation improves, and capnography shows a waveform if available. [1]

  7. Avoid air in the stomach

    Too much volume or speed fills the stomach and causes vomiting. Watch the abdomen. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

45 VMS cases train this skill: open the case library

Sources

  1. NREMT psychomotor skill sheets (EMT and Paramedic)
  2. AHA Guidelines for CPR and ECC

Facts and steps follow NREMT psychomotor skill sheets (EMT and Paramedic). VMS is not affiliated with these organizations. Updated: 2026-10-11.