Bag-valve-mask (BVM) ventilation: a guide for nursing students

Bag-valve-mask (BVM) ventilation is the most important manual airway skill in nursing. When a patient stops breathing — or cannot breathe adequately — a correctly applied BVM delivers oxygen and ventilation in seconds without intubation. Every nurse practicing in any setting where patients can deteriorate must be competent with BVM. A poorly sealed mask delivers no air to the lungs regardless of how vigorously the bag is squeezed; a bag squeezed too hard inflates the stomach, triggers vomiting, and risks aspiration. The margin between effective rescue ventilation and a potentially fatal mistake is technique, not effort.

This guide covers the BVM’s components, correct mask sizing, the E-C clamp and two-person techniques, tidal volume and rate targets across the lifespan, oxygen delivery, airway adjuncts, special populations, and the errors most likely to harm a patient — and appear on NCLEX.

Quick-reference summary

What is a BVM?

A BVM is a self-contained manual ventilation device. It delivers positive-pressure ventilation without an external power source, making it the default airway tool in cardiac arrest, respiratory failure, and procedural sedation. The device is commonly called an Ambu bag — a brand name that has become generic, in the same way “Kleenex” is used for any facial tissue.

Understanding each component is essential for troubleshooting on the fly. If ventilation fails, you need to know immediately which part of the circuit has failed.

How oxygen delivery works

The BVM is a self-inflating device. When you release the bag, it draws gas in through the inlet valve. If a reservoir bag is attached and the O₂ flow rate matches or exceeds consumption, the reservoir fills with 100% oxygen between each compression. The next squeeze delivers that oxygen-enriched gas to the patient.

Without a reservoir: The bag re-inflates with a mixture of room air (21% O₂) drawn through the air-intake port and whatever residual oxygen remains. FiO₂ typically reaches only 40–60%, even at 10–15 L/min — insufficient for a patient in respiratory arrest.

With reservoir at 10–15 L/min: FiO₂ approaches 90–95%. This is the target configuration for any adult or pediatric patient in acute distress.

Flow rate matters: Running oxygen at less than 10 L/min does not fill the reservoir fast enough to maintain high FiO₂. Many nurses instinctively set oxygen at 6–8 L/min because that is a typical nasal cannula setting — this is an error. BVM oxygen flow should be 10–15 L/min unless the clinical situation specifically calls for lower FiO₂ (e.g., COPD with hypoxic drive concerns, or a neonate where targeted SpO₂ ranges apply).

Mask sizing

An ill-fitting mask is the most common cause of failed BVM ventilation. Even perfect bag compression delivers nothing if there is a leak at the face. The mask must cover from the bridge of the nose to the chin cleft — it must not cover the eyes (which triggers eye injury from pressure and breaks the seal at the top) and must not slip below the chin.

Practical sizing rule: Hold the mask at the bridge, with the apex pointing toward the patient’s nose. It should span from the nasal bridge to the chin cleft without reaching the eyes and without the edge dropping below the lower border of the mandible. If the mask covers any part of the eye orbit, size down. If it does not reach the chin cleft, size up.

E-C clamp technique (one-person BVM)

The E-C clamp is the standard one-person mask seal technique. It is named for the hand positions used to hold the mask: three fingers form an “E” on the jaw; thumb and index finger form a “C” over the mask.

Setup: Position yourself at the patient’s head. Tilt the head (jaw thrust if cervical spine injury is possible). Place the mask with the apex on the nasal bridge and the base in the chin cleft.

Left hand (dominant or non-dominant — use whichever provides better control):

• Thumb — pressed on the left side of the mask body near the top, pointing toward the patient’s nose
• Index finger — pressed on the left side of the mask body near the connector port, curled around to form the top of the “C”
• Middle finger — hooks under the mandible at the mental protuberance (chin) — first finger of the “E”
• Ring finger — hooks under the mandible, posterior to middle finger — second finger of the “E”
• Little finger — hooks under the angle of the mandible — third finger of the “E”

The E-fingers pull the jaw upward into the mask while the C-fingers press the mask down against the face. The seal comes from this opposing pressure — jaw up, mask down — not from pressing the mask hard against the face.

Right hand squeezes the bag.

Common E-C errors:

• Fingers pressing on soft tissue of the neck (compresses airway, triggers vagal response)
• Insufficient jaw thrust — mask seal requires an open airway beneath it
• Pressing the mask too hard into the face without the counterforce of jaw tilt — this flattens the mask cushion and paradoxically worsens the seal
• Using the E-fingers on the cheek instead of the mandible — provides no airway lift

Two-person BVM technique

Two-person BVM is superior to one-person in every measurable way. One operator using both hands to hold the mask achieves a dramatically better seal than one operator splitting attention between mask and bag. The second person squeezes the bag with both hands, allowing better tidal volume control.

When to use two-person:

• Any patient with a difficult airway (beard, obesity, facial trauma, large face)
• Prolonged ventilation before intubation
• Whenever a second provider is available — this should be the default in a code situation, not the exception

Mask holder position (operator 1):

• Both thumbs on the mask body, one on each side, angled toward the nose apex
• Both index fingers mirroring on the lower mask body, angled toward the chin
• Remaining fingers (middle, ring, little) of both hands along the lateral mandible, lifting the jaw bilaterally
• This creates a bilateral jaw thrust with symmetric mask compression — the most effective seal achievable without an advanced airway

Bag squeezer position (operator 2):

• Both hands on the bag
• Compress smoothly and steadily over 1 second for an adult; do not jam the bag
• Watch for visible chest rise — that confirms tidal volume and seal simultaneously

Communication: The bag squeezer should call each breath (“breath going in”) so the mask holder can confirm chest rise before the next compression. In a code situation with CPR, coordination prevents the bag squeezer from compressing during chest compressions (which would fight against them).

Tidal volume targets and ventilation rates

Over-ventilation is the most dangerous BVM error in cardiac arrest. Every unnecessary breath delivered during CPR increases intrathoracic pressure, reduces venous return, decreases coronary perfusion pressure, and reduces the likelihood of ROSC. The instinct to ventilate aggressively must be suppressed in favor of metered, guideline-driven breaths.

Tidal volume in practice: Most adult BVM bags hold 1,500 mL. Squeezing the full bag delivers far more than the 500–600 mL target. For an average adult, compress the bag roughly one-third to one-half of its full volume with one hand, or use a controlled two-hand squeeze. The chest should visibly rise — not heave. If the chest heaves, the tidal volume is excessive.

Pediatric volumes: The pediatric bag (~450–500 mL) should be compressed with two or three fingers, not a full palm squeeze. Over-ventilation in small patients inflates the stomach rapidly, causing regurgitation within minutes. The pop-off valve provides a pressure ceiling, but it does not prevent the rapid gastric insufflation that follows repeated over-ventilation.

Airway adjuncts: OPA and NPA

A BVM mask provides oxygen delivery but does nothing to prevent airway obstruction from posterior tongue displacement. In an unconscious patient, the tongue falls against the posterior pharyngeal wall and blocks airflow. Jaw tilt and chin lift help — but airway adjuncts are more reliable and allow more consistent ventilation.

Oropharyngeal airway (OPA)

An OPA is a curved plastic or rubber device inserted into the mouth that mechanically displaces the tongue anteriorly, establishing a patent oropharyngeal channel.

Indication: Unconscious patient with no gag reflex. Never in a patient with intact gag — it will trigger vomiting and laryngospasm.

Sizing: Measure from the center of the mouth (corner of the lip) to the angle of the mandible. Alternatively, measure from the center of the lips to the earlobe — the OPA tip should reach the posterior pharynx. An OPA that is too short does not displace the tongue; too long pushes the epiglottis against the posterior pharynx and worsens obstruction.

Insertion: In an adult, insert with the curved tip pointing toward the roof of the mouth (concave upward), then rotate 180° as the device passes the posterior hard palate so the curve follows the tongue anatomy. In an infant or child, do NOT rotate — insert with the curve following the tongue (concave downward) using a tongue blade to depress the tongue and guide insertion straight back. Rotation in a child risks airway trauma and dental avulsion.

After insertion: The flange should rest at the lips. The OPA does not prevent aspiration — if the patient vomits, the nurse must remove the OPA and suction immediately. Review airway suctioning for technique after OPA removal in a vomiting patient.

Nasopharyngeal airway (NPA)

An NPA is a soft rubber or latex tube inserted through the nostril that creates a patent channel from the nasal passage to the posterior pharynx, bypassing the tongue.

Indication: Patients with an intact or partially intact gag reflex who will not tolerate an OPA; trismus; jaw fracture; patients whose teeth or jaw anatomy prevents OPA insertion; ongoing seizure where oral access is impossible.

Contraindication: Suspected basilar skull fracture (raccoon eyes, Battle’s sign, hemotympanum, CSF rhinorrhea). In this situation, a nasally-inserted device can enter the cranial vault.

Sizing: Measure from the tip of the nose to the earlobe (or tragus). Diameter should approximate the patient’s smallest fingernail width or the diameter of the external nares. An NPA that is too long can enter the larynx and cause laryngospasm.

Insertion: Lubricate generously with water-soluble lubricant. Insert bevel-side toward the nasal septum (bevel toward the side of insertion in some protocols). Advance along the floor of the nasal passage, not superiorly. If resistance is felt, do not force — attempt the other nostril.

Gastric insufflation and the Sellick maneuver

Gastric insufflation is a direct consequence of BVM over-ventilation. When airway pressure exceeds the lower esophageal sphincter opening pressure (approximately 20–25 cm H₂O), gas is forced into the stomach. This produces four problems: gastric distension reduces diaphragm excursion and worsens ventilation; it dramatically increases regurgitation risk; if the patient vomits during BVM, aspiration is immediately life-threatening; and it falsely reassures the provider that ventilation is adequate when stomach inflation is mistaken for chest rise.

Prevention:

• Tidal volume 6–8 mL/kg — not more
• Inspiratory time ~1 second — do not rush the breath in
• Ensure adequate mask seal and open airway before squeezing (if the airway is obstructed, all pressure goes into the stomach)
• Two-person technique is protective — better seal means lower pressure required per breath
• Insert an OPA or NPA if the patient is unconscious — reduces airway resistance and required bag pressure

Cricoid pressure (Sellick maneuver): This technique involves applying posterior pressure to the cricoid cartilage to compress the esophagus against the vertebral body, theoretically preventing passive regurgitation and reducing gastric insufflation during BVM. It was standard teaching for decades.

Current evidence does not support routine use. The 2015 ILCOR guidelines state that cricoid pressure during CPR may impede ventilation and intubation and is not recommended as a standard intervention. Meticulously applied cricoid pressure by a trained provider in RSI for patients at high aspiration risk (not in full arrest) remains a clinical judgment decision — but nursing students should know that the evidence is conflicting and that ILCOR does not endorse it routinely. Do not expect cricoid pressure to appear as the “correct answer” on NCLEX for preventing gastric insufflation during BVM — correct tidal volume and technique are the primary answers.

BVM during CPR

Cardiac arrest changes BVM priorities. Rapid response and code blue situations require both effective ventilation and preservation of chest compression quality — these two goals are in direct tension.

Before an advanced airway is placed (30:2 ratio):

During CPR, BVM is used in a synchronized 30:2 compression-to-ventilation ratio for adult single- or two-rescuer CPR. Pause compressions for the two breaths. Each breath should be delivered over 1 second. Resume compressions immediately. Do not pause more than 10 seconds for ventilation. Two-person BVM with one provider compressing and one managing the airway is the target configuration.

For two-rescuer pediatric CPR, the ratio is 15:2. For neonatal resuscitation, 3:1.

After an advanced airway is placed:

Once an endotracheal tube or supraglottic airway (LMA, King LT, i-gel) is in place and confirmed, ventilation becomes asynchronous with compressions. Compressions continue without pause while a second provider delivers 1 breath every 6 seconds (10/min) for adults. This is one of the most-tested NCLEX distinctions: the ratio changes only before advanced airway placement — after placement, ventilation is continuous at 10/min regardless of compressions.

Over-ventilation risk in cardiac arrest: Each breath during CPR transiently increases intrathoracic pressure, impairs venous return, and reduces coronary perfusion. AHA guidelines explicitly identify over-ventilation as a resuscitation error that worsens outcomes. If your institution tracks ETCO₂ on intubated arrest patients, values below 10 mmHg at 20 minutes predict non-ROSC; values above 40 mmHg correlate with ROSC. See cardiac monitoring and telemetry for monitoring context in cardiac arrest.

PEEP valve use with BVM

A PEEP valve attaches inline between the BVM patient valve and the mask (or ET tube adapter). It is a spring-loaded or dial-adjustable device that maintains continuous positive airway pressure throughout the ventilatory cycle by creating resistance to expiratory flow.

When to use: Severe hypoxemia unresponsive to high-flow oxygen alone; suspected or confirmed ARDS; pulmonary edema; patients bridging to intubation or mechanical ventilation who require PEEP to maintain alveolar recruitment. For context on how PEEP functions in mechanical ventilation, see the mechanical ventilation nursing guide.

Settings: Typical BVM PEEP valves are adjustable from 2.5 to 20 cm H₂O. Clinical PEEP settings during bridging ventilation are usually 5–10 cm H₂O. Higher PEEP (10–15 cm H₂O) may be used with provider guidance for refractory hypoxemia.

Practical considerations: Adding a PEEP valve increases inspiratory work and bag resistance. The person squeezing the bag must apply more force to deliver the target tidal volume. Monitor for chest rise carefully. The two-person technique is strongly preferred when a PEEP valve is in use. PEEP valves also increase the risk of gastric insufflation at higher settings — airway patency and appropriate tidal volumes become even more critical.

BVM with tracheostomy or stoma

Patients with a tracheostomy or laryngectomy stoma require modified BVM technique. The principles are identical — deliver positive-pressure ventilation through the airway — but the interface changes.

Tracheostomy patients: Connect the BVM directly to the 15 mm adapter on the tracheostomy tube. This is the easiest and most reliable configuration. If the tracheostomy tube is cuffed, inflate the cuff before ventilating to prevent leak. If a cuffless or fenestrated tube is in place, BVM ventilation via the tube may produce a significant leak — close the patient’s mouth and nose with your hand while ventilating through the tube. See the tracheostomy nursing guide for detail on cuff management and tube obstruction.

Laryngectomy patients (stoma ventilation): A laryngectomized patient has no connection between the oropharynx and the lungs — the trachea has been surgically brought to a skin-level stoma. Applying a BVM mask to the face delivers air to a dead end.

For a laryngectomy patient in respiratory distress:

1. Uncover the stoma
2. Place a pediatric mask directly over the stoma (the stoma diameter is typically small enough that a pediatric round mask creates a seal)
3. Or use a tracheostomy-specific adapter if available
4. Close the mouth and nose — these are disconnected from the airway but can leak around the mask if not occluded
5. Ventilate directly through the stoma at standard adult parameters

If the stoma is obstructed, suction first. Do not attempt to intubate orally in a complete laryngectomy patient — it will not succeed.

Pediatric and neonatal BVM considerations

Pediatric patients

Children are not small adults for the purposes of BVM ventilation. The differences are not merely size — they are anatomic, physiological, and pharmacological. Key pediatric BVM distinctions:

• Higher rates: Pediatric and infant metabolic demands require 12–20 breaths/min vs 10–12 for adults.
• Smaller tidal volumes: Infants and small children require 2–3 finger compressions of the pediatric bag, not a full palm squeeze.
• Faster gastric insufflation: The pediatric lower esophageal sphincter opens at lower pressures. Gastric inflation occurs quickly and can be severe. Insert an appropriately sized OPA when the patient is unconscious.
• Pop-off valve: Pediatric BVMs include a pressure-limiting valve set at 35–45 cm H₂O. In poor lung compliance scenarios (bronchospasm, pneumonia, meconium), the valve may limit adequate tidal delivery — it can be manually occluded by a trained provider.
• HR is the primary resuscitation endpoint in children: Unlike adults, pediatric cardiac arrest is usually hypoxic in origin. Heart rate normalization (HR > 100 bpm in infants) after effective BVM ventilation confirms adequacy. In pediatric patients, refer to the pediatric nursing reference for age-specific vital sign norms.

Neonatal resuscitation

Neonatal BVM ventilation follows Neonatal Resuscitation Program (NRP) guidelines, which differ significantly from PALS and ACLS.

Preferred device: The NRP guidelines prefer a T-piece resuscitator (e.g., Neopuff) over a self-inflating BVM for neonatal resuscitation because the T-piece delivers consistent tidal volumes, controllable peak inspiratory pressure (PIP), and PEEP — none of which can be reliably achieved with a standard BVM in the hands of a single provider. A BVM without a manometer does not allow real-time PIP monitoring. When a T-piece is unavailable, a neonatal BVM is acceptable.

Parameters for neonatal BVM:

• Rate: 40–60 breaths/min
• PIP: 20–25 cm H₂O for most newborns
• Initial inflation breath: 30 cm H₂O for a meconium-stained airway to overcome surfactant deficiency and fluid-filled airways
• PEEP: 5 cm H₂O if T-piece or PEEP-capable device available
• Starting FiO₂: 21% (room air) for infants ≥35 weeks gestation; 21–30% for preterm infants; titrate to SpO₂ targets per NRP algorithm

Adequacy endpoint in neonates: Heart rate is the primary indicator. If HR increases to > 100 bpm within 30 seconds of effective positive-pressure ventilation (PPV), BVM is working. If HR does not respond, reassess the BVM seal, airway position, and tidal volume before escalating to intubation. For more on neonatal resuscitation contexts, see neonatal resuscitation nursing and neonatal RDS nursing.

Common nursing errors in BVM ventilation

The following errors appear on NCLEX because they represent real harm. Each error has a specific mechanism of injury.

1. Inadequate mask seal — the most common failure mode. Leaks around the mask mean the patient receives no ventilation regardless of bag compression. The bag feels like it compresses normally because it does — the air just goes around the mask instead of into the patient. Check for chest rise on every breath. If there is no visible rise, reposition the mask before compressing again.

2. Over-ventilation: excessive rate — especially in cardiac arrest. Providers under stress instinctively ventilate too fast. At rates above 12/min during CPR, intrathoracic pressure rises, venous return falls, and coronary perfusion pressure drops. Use a visible clock or count aloud.

3. Over-ventilation: excessive volume — squeezing the bag fully in an adult or using an adult bag on a pediatric patient. Chest should rise visibly, not heave. If you can see the abdomen rising, the stomach is being inflated.

4. Wrong oxygen flow rate — setting O₂ at 2–6 L/min (nasal cannula rates) when the BVM requires 10–15 L/min. At low flow rates, the reservoir cannot fill between compressions and FiO₂ drops toward 40–50% — inadequate for most emergencies.

5. Failure to assess chest rise — compressing the bag and watching the monitor instead of watching the chest. Chest rise is the primary confirmatory sign for every breath. Waveform capnography and SpO₂ are secondary.

6. Not suctioning before BVM in secretion-loaded patient — applying BVM over a mouth full of vomitus, blood, or secretions forces material into the lungs. Suction first using the airway suctioning technique — even 15 seconds of suctioning is worthwhile before initiating ventilation.

7. Failing to insert OPA in unconscious patient without gag reflex — ventilating against posterior tongue obstruction without an adjunct requires higher bag pressures, which accelerates gastric insufflation. An OPA dramatically reduces airway resistance in these patients.

8. Cricoid pressure disrupting intubation — if a provider applies cricoid pressure during intubation and the laryngoscopist cannot visualize the cords, release the cricoid pressure immediately rather than maintaining a practice with equivocal evidence.

9. Wrong mask size — using a mask that covers the eyes (too large) breaks the apical seal and causes eye pressure injury. Using a mask too small creates a perimeter gap at the chin. Always confirm fit before ventilating.

10. Forgetting to confirm tube position after intubation — BVM is often used until intubation. After tube placement, immediately confirm position with waveform capnography, bilateral breath sounds, and chest rise before continuing ventilation. Esophageal intubation while BVM-ventilating is a sentinel event.

NCLEX high-yield tips

These are the BVM ventilation concepts most consistently tested on NCLEX. Each tip represents an area where the plausible-sounding wrong answer is the one most students select.

1. Adult BVM rate is 10–12 breaths/min. Not 12–20 (pediatric). Not 30:2 (that is the CPR ratio). 10–12/min for a non-arrested adult.

2. Pediatric/infant BVM rate is 12–20 breaths/min. Higher rate reflects higher metabolic demand. The question may ask you to differentiate adult from pediatric rates — know both.

3. Newborn BVM rate is 40–60 breaths/min. This is unusually fast and commonly appears as a “trick” option in NCLEX questions. It is correct.

4. E-C clamp: E = three fingers on jaw (lift), C = thumb + index finger on mask (press). Questions will describe the hand position and ask you to identify the technique, or describe an error (E-fingers on cheek = wrong).

5. Two-person BVM is superior to one-person. The mask holder uses both hands for bilateral jaw lift and mask seal — far better seal than one-person. Select two-person whenever two providers are available.

6. Signs of effective BVM ventilation: bilateral chest rise, improving SpO₂, heart rate normalization in pediatric patients. In cardiac arrest, waveform capnography with ETCO₂ ≥ 10 mmHg also confirms ventilation. Stomach rising is not a sign of adequate ventilation — it indicates gastric insufflation.

7. Gastric insufflation prevention: correct tidal volume + correct rate + patent airway. The NCLEX answer for preventing gastric insufflation is ensuring the airway is open (head-tilt chin-lift, OPA if appropriate), maintaining tidal volume at 6–8 mL/kg, and not over-ventilating. Cricoid pressure is NOT the NCLEX-primary answer.

8. CPR 30:2 ratio is for before advanced airway placement. Once an ET tube or supraglottic airway is confirmed, switch to continuous compressions plus 1 breath every 6 seconds (10/min) asynchronously. This is heavily tested.

9. After advanced airway: 1 breath every 6 seconds = 10/min asynchronous. Compressions do not stop for breaths. This is the opposite of the 30:2 rule and students frequently mix them up.

10. Reservoir bag must be attached and oxygen running at 10–15 L/min to achieve ~90–95% FiO₂. Without the reservoir, FiO₂ is only 40–60% even at 10–15 L/min oxygen flow. Without oxygen flow at all, the patient breathes room air (21%).

11. OPA sizing: corner of mouth to angle of jaw (or corner of lips to earlobe). Too short = doesn’t displace tongue. Too long = pushes epiglottis into pharynx. OPA is contraindicated in patients with intact gag reflex.

12. OPA insertion in adults: rotate 180°. In children: do NOT rotate — use tongue blade. Rotation in a child risks injury. This distinction is frequently tested.

13. NPA contraindicated in suspected basilar skull fracture. Raccoon eyes, Battle’s sign, hemotympanum, and CSF rhinorrhea are the clinical signs. Any of these = no NPA.

14. NPA sizing: tip of nose to earlobe. Diameter approximates the nares. Too long risks laryngospasm.

15. Pop-off valve on pediatric BVMs is set at 35–45 cm H₂O. It can be manually occluded in poor-compliance situations by a trained provider. Its purpose is prevention of barotrauma, not tidal volume delivery.

16. PEEP valve increases resistance — two-person BVM preferred when PEEP is used. Adding PEEP improves oxygenation in ARDS and pulmonary edema but increases the force needed to deliver each breath.

17. Laryngectomy patients: apply BVM to stoma, not the face. A laryngectomy stoma is the only airway. The face is a dead end. Close the mouth and nose. Use a pediatric mask over the stoma.

18. Neonatal resuscitation: HR > 100 bpm within 30 seconds of effective PPV is the primary success indicator. If HR does not increase, reassess BVM technique before escalating.

19. Neonatal preferred device is T-piece resuscitator, not BVM. BVM is acceptable when T-piece is unavailable. NRP preference is T-piece because it delivers consistent PIP and PEEP.

20. Over-ventilation during CPR worsens outcomes. AHA guidelines identify over-ventilation as a harmful resuscitation error. Every unnecessary breath raises intrathoracic pressure, reduces venous return, and lowers coronary perfusion pressure.

NCLEX practice questions

Related skills

BVM ventilation does not exist in isolation — it is one technique within a broader respiratory and resuscitation skill set. The oxygen therapy nursing guide covers the full range of oxygen delivery devices from nasal cannula to non-rebreather mask, providing context for how BVM fits into the oxygen delivery spectrum. When a patient deteriorates beyond BVM capacity, the mechanical ventilation nursing guide covers how positive-pressure ventilation is continued with a ventilator. Understanding airway management is inseparable from airway suctioning, particularly suctioning before BVM application and suctioning via OPA during ongoing ventilation. Patients who require BVM most urgently are those in cardiac arrest or rapid response situations — those guides provide the full clinical picture of which BVM decisions occur in which phases of resuscitation. For patients with a surgical airway, the tracheostomy nursing guide covers modified BVM interfaces, cuff management, and stoma ventilation in detail. Pediatric-specific BVM decisions connect to pediatric nursing reference parameters, and neonatal BVM care is further addressed in neonatal resuscitation nursing.

Clinical references: American Heart Association — 2020 AHA Guidelines for CPR and Emergency Cardiovascular Care; International Liaison Committee on Resuscitation (ILCOR) — 2015 Consensus on Science and Treatment Recommendations; American Academy of Pediatrics / American Heart Association — Neonatal Resuscitation Program (NRP) 8th edition (2021); Walls RM, Murphy MF (eds.) — Manual of Emergency Airway Management, 5th edition; Perry AG, Potter PA, Ostendorf W — Clinical Nursing Skills and Techniques, 10th edition; Weingart SD, Levitan RM — “Preoxygenation and prevention of desaturation during emergency airway management” (Annals of Emergency Medicine, 2012); Aufderheide TP et al. — “Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation” (Critical Care Medicine, 2004); StatPearls — Bag Mask Ventilation (Roberts et al., 2024).