Bag–mask ventilation in a child: watch the chest, not the bag

The most reliable guide to adequate tidal volume in a child is visible, gentle chest rise. Squeeze only until the chest starts to rise, then release; overinflation causes gastric distension and reduces venous return.

Use a bag and mask sized for the child, open the airway with head position and jaw thrust, and check the seal before blaming the bag. In children, respiratory arrest commonly precedes cardiac arrest, so effective ventilation is often the intervention that matters most.

• Squeeze until the chest just begins to rise, then let go
• Choose a mask that covers mouth and nose without pressing on the eyes
• Use head position and jaw thrust to open the airway before ventilating
• Switch to a two-person technique if you cannot get a seal

Why it matters

In children, getting oxygen in often matters more than anything else in a resuscitation.

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