focus on Bag-Valve-Mask Devices in Nepal hospitals

This will be a short post.


CCNEPal always goes over bag-valve-mask devices as part of the 2-day and 3-day class. We have decided to amplify the material we give students on this subject. We did some internet research and wrote an eight-page document about these important yet overlooked tools.

Acknowledgement of source material

Let me say, right up front, the primary source was a brochure by the Laerdal Corporation. This was excellent, but the original was written in such small text that it did not photocopy well. Also, most Nepal hospitals use less expensive bags from a Chinese source that does not supply a manufacturer’s brochure along with their bag.


and where would we be without YouTube?

There are several videos. One describes the procedure for assembling the bag-valve-mask.


It turns out, this is a popular topic. here is a good one.

There is a list of about fifty videos that describe various aspects.

If you want a copy of this eight-page document, please send an email to



About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
This entry was posted in medical volunteer in Nepal and tagged , , . Bookmark the permalink.

3 Responses to focus on Bag-Valve-Mask Devices in Nepal hospitals

  1. I know working as a paramedic, we frequently use bag valve masks (BVM) and have learned that although it is most often used by one person, it is really a two person job, because to maintain an effective seal, two hands are usually required. That means you need a second person to actually compress the bag. Studies have been done on the amount of oxygen lost using the bag with one person. There are exceptions, like some one with extra large, strong hands and if I have been tasked to use the BVM and we are working on a patient on the ground (paramedic, remember? Lol) I can use both my hands to form the seal and my knee to compress the bag against the ground, but that only works until we have to move. Then if I can’t find a spare set of hands it is back to the inefficient bagging method. Now, I know you are talking about pediatrics and depending on the size of the child one person can usually bag efficiently. Other things you may know but that I have learned over the years, even experienced personnel tend to hyperventilate patients, giving them nearly twice the number of breaths required in a minute, if they are not watching a clock or a watch to keep track. It is believed this could be due to the adrenaline in our systems, causing us to think time is passing faster, then it really is. Also, a special thing about children, generally the pre- pubescent ones, if you can get to a child fast enough after they go into respiratory arrest, often just a few mouth -to-mask (or mouth, if no mask is available), especially if oxygen is available to attach to the mask, breaths are needed to get the child breathing again. It is amazing how quickly they recover. I have actually seen this work, been the one to do this, and it never fails to amaze me. I wish you all the best and keep you in my prayers.
    Tracy Jillard

    • you make excellent points. I do cover these exact same things – great minds think alike!

      hey, come to Kathmandu and teach with us!

      • I have always wanted to volunteer my skills elsewhere in the world. Initially, it was money that stopped me, now besides money, I am on narcotics due to cervical radiculopathy in my left shoulder and arm, and a non-union fracture that is going on a year now (they are trying something new now -a bone stimulating generator. If that doesn’t work, then surgery. Due to all of this my certifications have expired.( trying to work on that one, even offered to go through school again. I have always loved learning about other cultures ( I was learning 20 something languages one word at a time.) I speak a little French and some American Sign Language (ASL). If I can get well and find the money, I’ll let you know. Take care and stay safe-to you and your crew.
        P.S. If you get a chance, send me a post card. I keep you all in my prayers always. T.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s