What are the key features and indications for using a bag-valve-mask (BVM) with oxygen in the field?

• A. Indicated for apneic or inadequately breathing casualties; use with 15 L/min oxygen; ensure proper seal and adequate chest rise
• B. Indicated only for patients who are breathing spontaneously; no oxygen required
• C. Used without checking chest rise; no need for a proper seal
• D. Preferred for conscious patients only

Answer: (A)

A bag-valve-mask with oxygen is used when the casualty is not breathing or is breathing inadequately, so they need ventilation and a high concentration of oxygen. In the field you connect the BVM to oxygen at a high flow, typically about 15 liters per minute, to fill the reservoir and deliver the greatest possible oxygen to the patient. A proper seal around the mouth and nose is essential to prevent air leaks, and you should see the chest rise with each squeeze, confirming effective ventilation. Deliver breaths in a controlled, steady rhythm and avoid excessive force to prevent gastric distension and other complications. This approach isn’t appropriate for someone who is breathing adequately on their own, and you should always verify chest rise and maintain a good seal rather than assuming ventilation is happening.