Skill sheet · About 5 minutes
BVM Ventilation of an Apneic Adult
This station looks simple and fails students constantly, almost always for rate, volume, or a missed adjunct. The examiner is watching for visible chest rise at 10–12 breaths per minute with high-flow oxygen connected.
Step-by-step order
- Verbalize BSI and PPE precautions.
- Check responsiveness and assess breathing for no more than 10 seconds.
- Open the airway with a head-tilt chin-lift (jaw thrust if trauma is suspected).
- Insert an appropriately sized oropharyngeal airway, measured corner of mouth to earlobe.
- Begin ventilation with the BVM on room air within 30 seconds while your partner connects oxygen.
- Attach the reservoir bag to oxygen at 15 L/min.
- Ventilate at 10–12 breaths per minute, one second per breath, to visible chest rise.
- Reassess: chest rise, no gastric insufflation, improving color, and a pulse check.
- Verbalize continued ventilation and transport.
Critical fail criteria
- Failed to take or verbalize BSI precautions.
- Failed to voice or attempt to open the airway.
- Failed to check responsiveness and breathing.
- Failed to begin ventilation within 30 seconds or interrupted ventilation for more than 30 seconds.
- Failed to ventilate at 10–12 per minute with adequate volume.
- Failed to connect the BVM to high-flow oxygen with a reservoir.
- Failed to insert an airway adjunct.
Say-it-out-loud script
Examiners score what they hear. Narrate the station: "BSI in place. Patient is unresponsive, no breathing, I'm opening the airway with a head-tilt chin-lift. Inserting an OPA measured corner of the mouth to the earlobe. Beginning ventilations — one, two — partner, connect oxygen at 15 liters. Good chest rise, no gastric distension."
FAQ
What ventilation rate does the NREMT BVM station require?
10–12 breaths per minute for an adult, one breath every 5 to 6 seconds, each delivered over about one second to visible chest rise.
Do I ventilate before oxygen is connected?
Yes. Ventilation must begin within 30 seconds. Start on room air and have your partner attach high-flow oxygen with a reservoir bag.
What if I do not see chest rise?
Reposition the head, reseal the mask with a two-handed technique, then check for an obstruction. Adding volume without a seal only inflates the stomach.
More skill sheet walkthroughs
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