Bag-Valve-Mask O2 Ventilation

Efficiency Versus Convenience; O2 Versus Valve Lock
  • James O. Elam


The self-refilling bag-valve unit is a superior device for ventilation during cardiopulmonary resuscitation (CPR) as soon as the trachea is intubated and oxygen is available, particularly during transport of the cardiac arrest patient. As resuscitation technology has evolved, the role of the bag-valve assembly has changed from a mask unit utilizing air to a superb manual device for delivering ventilation with a high oxygen concentration via tracheal tube or equivalent airway (1–25). Bag-valve-mask resuscitation must be considered in terms of the requisite skill, experience, and judgment of the operator, and the limitations imposed by gastric complications. Prevention of regurgitation and pulmonary aspiration with the use of bag-valve-mask units is possible with the use of tracheal intubation and the esophageal obturator airway (EOA), or the esophageal pharyngeal airway (EPA) (26).


High Oxygen Concentration Coil Spring Cardiac Arrest Patient Lung Inflation Expiratory Positive Airway Pressure 
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  1. 1.
    Ruben H: A new non-rebreathing valve. Anes-thesiology 16: 643, 1955Google Scholar
  2. 2.
    Ruben H, Ruben A: Apparatus for resuscitation and suction. Lancet 2: 373, 1957CrossRefGoogle Scholar
  3. 3.
    Ruben H: Self-contained resuscitation equipment. Can Med Assos J 80: 44, 1959Google Scholar
  4. 4.
    Ruben H, Knudsen EJ, Winkel E, et al: Eine Narkosenmethode die auch in Katastrophensituationen gebraucht werden kann. Anaesthetist 7: 161, 1958Google Scholar
  5. 5.
    Elam JO: Insufflation methods with simple equipment. In Whittenberger JL (ed): Artificial Respiration: Theory and Applications. New York, Hoeber, 1962, pp 105–146Google Scholar
  6. 6.
    Saklad M, Gulati R: Adaptation of ambu respirator for high oxygen concentration. Anesthesiology 24: 877, 1963PubMedCrossRefGoogle Scholar
  7. 7.
    Jude JR, Elam JO: Fundamentals of Cardiopulmonary Resuscitation. Boston, Davis, 1965, pp 53–59Google Scholar
  8. 8.
    Carden E, Bernstein M: Investigation of the nine most commonly used resuscitator bags. JAMA 212: 589, 1970PubMedCrossRefGoogle Scholar
  9. 9.
    Karl WF: Oxygen concentrations achieved with manual resuscitator. MY State J Med 66: 2018, 1966Google Scholar
  10. 10.
    Elam JO, Greene DG, Brown ES, et al: Oxygen and carbon dioxide exchange and energy cost of expired air resuscitation. JAMA 167: 328, 1958Google Scholar
  11. 11.
    Don Michael TA, Lambert EH, Mehran A: Mouth-to-lung airway for cardiac resuscitation. Lancet 2: 1329, 1968PubMedCrossRefGoogle Scholar
  12. 12.
    Elam JO, Kim IW, Robert MK, et al: Engineering and clinical assessment of valve-bag resuscitators. Proceedings of the National Conference on Standards for CPR and ECC. American Heart Association, National Academy of Sciences, National Research Council, Washington, D.C., May 16–18, 1973. Dallas, American Heart Association, 1975, pp 99–122Google Scholar
  13. 13.
    Nobel J, et al: Manually-operated emergency ventilation devices. Med Lett Drugs Ther 2: 54, 1969Google Scholar
  14. 14.
    Nobel J, et al: Manually-operated resuscitators. Health Dev 1: 13, 1971Google Scholar
  15. 15.
    Ziecheck HD, Nurick H, Fadale V: A method for increased inspired oxygen concentration with the Hope resuscitator. Respir Care 18: 409, 1973Google Scholar
  16. 16.
    Loehning RW, Davis G, Safar P: Rebreathing with “non-rebreathing” valves. Anesthesiology 24: 854, 1964CrossRefGoogle Scholar
  17. 17.
    Gordon AS: Bag-valve-mask units. Proceedings of Conference on Cardiopulmonary Resuscitation, National Academy of Sciences, National Research Council. Washington, D.C., 1967, pp 125–127Google Scholar
  18. 18.
    Kravath RE, Schonberg SK: Tension pneumothorax hazard. N Engl J Med 278: 1403, 1968PubMedGoogle Scholar
  19. 19.
    Loveday R, Hurter D: Hazard of self-inflating resuscitation bags. Br Med J 4: 111, 1969PubMedCrossRefGoogle Scholar
  20. 20.
    Pearson JW, Redding JS: Equipment for respiratory resuscitation. I. Anesthesiology 24: 739, 1963; II. Anesthesiology 25:858, 1964Google Scholar
  21. 21.
    Nobel J, et al: Evaluation of external cardiac compressors and gas-powered compressor ventilator. Health Dev 2: 136, 1973Google Scholar
  22. 22.
    Nobel J, et al: Manually-operated infant resuscitators. Health Dev 2: 240, 1973Google Scholar
  23. 23.
    Nobel J, et al: Manually-operated resuscitators. Health Dev 3: 164, 1974Google Scholar
  24. 24.
    Steinbach RB, Carden EC: 1973 assessment of eight adult resuscitator bags. Respir Care 20: 69, 1975PubMedGoogle Scholar
  25. 25.
    Breivik H: A safe multipurpose pediatric ventilation bag. American Society of Anesthesiologists meeting, Chicago, October 11–15, 1975Google Scholar
  26. 26.
    Elam JO, Tan P, Shafieha M, et al: This volume, Chapter 9Google Scholar
  27. 27.
    Ruben H: Combination Resuscitation and Aspirator, Anesthesiology 19: 408, 1958PubMedGoogle Scholar


  1. 1.
    Safar P, Lind B: Triple airway maneuver, artificial ventilation, and oxygen inhalation by mouth- to-mask and bag-valve-mask techniques. Proceedings of the National Conference on Standards for CPR and ECC, American Heart Association and National Research Council, May, 1973. Dallas, American Heart Association, 1975, pp 49–58Google Scholar

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© Springer-Verlag New York Inc. 1977

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  • James O. Elam

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