UMEM Educational Pearls

Bag-Valve-Mask Ventilation During OHCA

  • Current OHCA resuscitation guidelines recommend a 30:2 strategy of CPR with BVM ventilations.
  • Idris and colleagues performed a secondary analysis of the Resuscitation Outcomes Consortium CCC clinical trial to determine the incidence of BVM ventilation during a 30:2 CPR strategy and assess the association of detectable ventilations with patient outcomes.
  • In 1,976 patients, the authors found that only 40% of patients had detectable ventilations (> 250 ml) in more than half of CPR pauses.
  • For those patients with detectable ventilations in more than 50% of pauses, there was an association with increased survival to hospital admission, increased survival to hospital discharge, and increased survival with favorable neurologic outcome.
  • The current study highlights the importance of proper BVM ventilation during OHCA resuscitation and the opportunity to improve performance of this vital skill.


Idris AH, et al. Bag-valve-mask ventilation and survival from out-of-hospital cardiac arrest: A multicenter study.  Circulation. 2023;148:1847-56.