Exhaling During Manual Ventilation Is As Important As Inhaling

Exhalation during manual ventilation is as important as inhalation. One of my readers recently asked a very important question about ventilating a patient with a bag-valve-mask device: “Is there an outlet for the expired air of the patient?” The answer is yes. When ventilating a patient we are concentrating, and rightfully so, on watching the lungs expand and verifying that we hear breath sounds. It is just as important to verify that your patient can exhale. All ventilation devices have a built in pressure relief valve, also called a pop-off valve, which allows you to balance the force needed to expand the lungs with the ability to the patient to passively exhale. Failure to allow exhalation can lead to patient injury from barotrauma.

Illustration showing the parts of a bag-valve-mask device, using a self-filling bag as an example.

Common parts for bag-valve-mask devices, In this case a self-inflating style bag. The reservoir bag, when present, allows near 100% inspired oxygen if allowed to fill.

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