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Bag-Valve-Mask Training for Lifeguards
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Bag-valve-mask training for lifeguards exists because the device looks simple and is not. Most failures are seal failures, and a bag squeezed against a leaking mask delivers air to the room.
What does bag-valve-mask training teach lifeguards about getting a seal?
The E-C grip, one rescuer. Thumb and index finger form a C around the mask pressing it down; the remaining three fingers form an E along the jawbone, lifting the jaw up into the mask. You are lifting the face into the mask, not pressing the mask onto the face.
Two-person technique, preferred. One rescuer uses both hands to hold the seal and lift the jaw, the other squeezes the bag. This is substantially more effective and should be the default whenever a second rescuer is free.
Squeeze only until the chest rises. Then stop. That is the entire measure of a correct ventilation.
Over-ventilation does harm
Squeezing harder and faster is the instinct and it is wrong. Excess volume forces air into the stomach, which causes vomiting and aspiration in a casualty whose airway is already compromised. Excess rate raises pressure in the chest and reduces the blood returning to the heart, which undercuts the compressions.
Airway adjuncts
An oropharyngeal airway, sized from the corner of the mouth to the angle of the jaw, holds the tongue clear and makes a seal far easier. It is used only on a casualty with no gag reflex.
Connecting oxygen
Where the facility carries emergency oxygen, the bag connects to it and delivers a far higher concentration than the room air alone. Attach the reservoir and set the flow as trained.
Practise it, do not read it
The seal is a physical skill that fails quietly. A rescuer who has not practised recently will squeeze a bag against a leaking mask and believe they are ventilating, because the bag compresses either way. The chest rising is the only confirmation.
Bag-valve-mask training for lifeguards: frequently asked questions
How do you get a seal in bag-valve-mask training for lifeguards?
Use the E-C grip, with thumb and index finger pressing the mask down and the other three fingers lifting the jaw up into it. The two-person technique, one rescuer holding the seal with both hands while another squeezes, is more effective and should be the default.
How hard should you squeeze the bag?
Only until the chest rises, then stop. Over-ventilation forces air into the stomach causing vomiting and aspiration, and raises chest pressure which reduces blood returning to the heart.
How do you know the ventilation worked?
The chest rises. The bag compresses whether or not the mask is sealed, so a rescuer can believe they are ventilating while delivering air to the room.
Reviewed by Jackie Stern, Lifeguard Instructor, Firefighter and EMT. Jackie Stern has taught lifeguarding for more than 20 years and works as a firefighter, EMT and swim instructor. She reviews course content, prerequisites and rescue standards against current certification requirements.
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