NextGen Learning To Elevate Your Airway Practice
Introduction to Bag-Valve Mask
Optimzation & Best Effort for Effective Oxygenation
Bag-Valve Mask (BVM) ventilation is a foundational airway management skill, essential for providing oxygenation and ventilation in emergency settings. Despite its widespread use, ineffective BVM technique remains a leading cause of hypoxia and failed airway management. Mastering this skill requires deliberate practice, an understanding of optimal positioning, mask seal, and ventilation strategies, and the ability to adapt in real-time to a patient’s response.
The Vortex Approach emphasizes progressive best effort, meaning that clinicians should focus on optimizing variables before abandoning the technique when the initial attempt at BVM ventilation is sub-optimal. Small adjustments—such as changing head positioning, improving mask seal with a two-person technique, or integrating airway adjuncts—can dramatically enhance oxygenation and buy time for more advanced airway interventions.
Equally important is the ability to recognize when time and optimization options are no longer available. Knowing when to move on to another airway lifeline instead of making repeated attempts with the BVM is also crucial to building confidence with the device.
This session will provide the resources and practical, hands-on training in BVM techniques, ensuring that you can:
- Create an effective mask seal using various grip techniques (CE vs. VE grip).
- Optimize airway patency with head positioning, jaw thrust, and airway adjuncts.
- Use two-person techniques for improved oxygenation in challenging scenarios.
- Control ventilation pressure and rate to prevent gastric insufflation and barotrauma.
By the end of this session, you will be equipped with the skills to maximize your best effort in BVM ventilation, ensuring the highest possible success rate in airway management—whether as a primary or rescue technique.
Rapid Review
two thumbs down & jaw thrust up
What is the best way to use a BVM to provide lifesaving oxygen to a hypoxic patient in a rapidly evolving situation?
Two thumbs down with the jaw thrust up is our first go-to technique when you want your first attempt to be successful.
The Benefit of the Jaw Thrust
Why this Technique 🎧
Why do we recommend the two thumbs down with jaw thrust technique? It’s not about one size fits all but about the environment in which your knowledge is deployed. Listen here to find out what we mean.
Procedure Video
first effort BVM – step by step
You want you’re first attempt at face mask ventilation to be successful. This technique is the most likely to get you there. ✋
Optimization
what to do when you don’t get it right the first time
You don’t always get it right on the first try, so you need to be able to work in real-time to optimize your technique quickly. Optimization is important for two reasons: first, to oxygenate your patient successfully, and second to let you know that you’ve given it your best effort and it’s time to move on to another upper airway lifeline. Don’t waste time and effort repeating it if it isn’t working. MOVE ON!
Airway Adjuncts
Airway obstruction caused by the soft tissues of the oropharynx are a common cause of difficulty with FMV. The OPA and NPA are optimization tools to help bypass those obstructions. Learn how to place them here. ✋
The Bottom Line
This poster links to hands-on learning experiences in our immersive, interactive space. If you visit in person, be sure to stop by the corresponding station to practice your skills before heading over to one of our expert coaches for feedback.
What’s Next
Find Or Click Me
Nice work—you’re through this section! To keep going, scan the QR code on the physical poster at the next station in our pop-up training space to access the next set of digital content. Prefer to stay online? Just click the poster image here to continue your journey.
Dive Deeper
Would you like to continue on this journey? Below is a bundle of related content to explore, including content from other PAC learning spaces, great curated content, evidence-based resources, and network builders.
Blogpost
Anatomy of the BVM
A closer look at a BVM will give you a renewed appreciation for its design and will make your use of the device better. Let’s take a look 👇
Podcast
Why is BVM practice so bad?
& how to fix it
Join us as we explore the strange disconnect between this supposedly fundamental skill set and its real world implementation.
Curated MedEd
Build Your Network
Reuben Strayer is one of our favorites! We think you’ll enjoy his practical insights and dry wit in this video. Then follow him on Twitter to build your learning network.
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