During CPR, manual ventilation can save lives, but only when done right.
In cardiac arrest situations, bag-valve-mask (BVM) ventilation is one of the most critical and complicated skills a rescuer has to master. Yet despite its importance, it’s still often poorly performed—even by experienced professionals. Indeed, a recent study by the Paris Fire Brigade showed that even professional firefighters, among the mostly training rescuers in France, struggled with maintaining a proper mask seal. The result? High leakage, low tidal volumes, and suboptimal oxygenation.
If you want to improve BVM ventilation during CPR, start by addressing one of the biggest threats to ventilation quality: leakages. Here are five techniques to fix them and deliver better care.
- Size the mask right
Not too big, not too small. The right mask size covers the mouth and nose, follows facial contours, and reduces leakage from the start.
- Position the head, open the airway
Whether it’s a head-tilt/chin-lift or jaw-thrust, keeping the airway open helps reduce resistance, improve the seal, and reduce gastric insufflation. No open airway = no effective ventilation.
- Nail the hand grip
Seal matters. Use techniques like the E-O grip to create even pressure across the mask while lifting the jaw—not pushing the face down. Innovative and effective techniques, like the “OK” grip, are also taught at the Manual Ventilation Academy.
- Don’t crush the bag
Over-squeezing the bag is one of the most common mistakes during BVM ventilation. It increases airway pressure, worsens leaks, and reduces actual tidal volume. Gentle, controlled squeezes are far more effective. - Train with feedback
Even with perfect form, it’s nearly impossible to detect leaks without real-time monitoring. That’s why Ventilation Feedback Devices (VFDs) are a game-changer. They measure tidal volume, track leaks, and help you spot issues instantly.
Ready to master manual ventilation?
The Manual Ventilation Academy is here to close a critical gap in resuscitation training. While CPR education has made huge progress in chest compression quality, ventilation is still often overlooked, despite being just as vital.
At the Manual Ventilation Academy, we focus exclusively on teaching evidence-based manual ventilation techniques, combining simulation, hands-on practice, and real-time feedback. Our goal is to help every provider gain the confidence and precision needed to deliver life-saving breaths—every time.
👉 Whether you’re training a team or improving your own skills, the Manual Ventilation Academy is your go-to resource to raise the standard of care.