To optimize bag-valve-mask ventilation in an unconscious patient, which technique is preferred?

• A. Two-person technique
• B. One-person technique with head-tilt-chin lift
• C. Suctioning only
• D. Oropharyngeal airway alone

Answer: (A)

Optimal bag-valve-mask ventilation in an unconscious patient hinges on getting and keeping a tight mask seal while keeping the airway open. Using two rescuers achieves this best: one person forms and maintains a firm seal on the mask (often with a C-E grip and a jaw-thrust to keep the airway open), while the other squeezes the bag at a steady rate to deliver breaths with adequate volume. This division of labor reduces mask leaks, ensures better chest rise, and limits fatigue, leading to more effective ventilation.

A one-person technique is workable in a pinch, but it’s harder to maintain a good seal while simultaneously delivering breaths, which often results in more air leaks and inconsistent ventilation. Suctioning alone doesn’t provide breaths, and an oropharyngeal airway by itself doesn’t deliver ventilation—it's an adjunct to help maintain patency but must be used with a mask and bag to ventilate effectively.