How can you avoid forcing air into the stomach during bag-mask ventilation?

During bag-mask ventilation, the primary goal is to ensure that air is delivered effectively into the lungs rather than being forced into the stomach. One of the best strategies to achieve this is to squeeze the bag slowly while observing for chest rise. This approach allows the healthcare provider to apply gentle pressure, which is crucial for preventing over-inflation and reducing the risk of air entering the esophagus or stomach. Observing for chest rise is an immediate feedback mechanism indicating that air is entering the lungs, rather than the abdomen.

When ventilation is performed slowly, it allows for adequate time for the lungs to fill with air, providing a better chance to recognize ineffective ventilation if chest rise does not occur. If the bag is squeezed forcefully, it can rapidly inflate the lungs, but this may lead to increased pressure that does not give enough time for the airway to open, leading to air being pushed into the stomach. Additionally, the importance of monitoring the abdomen can help assess if air is entering the stomach, but this does not replace the benefit of controlling the ventilation rate and pressure administered through the bag. Thus, squeezing the bag slowly while observing for chest expansion is a critical skill for effective ventilation technique.