If you are like me and love to teach, then you try to make it as easy as possible for your students. When it comes to showing them how to use the Bag Valve Mask(BVM) some students have a problem grasping the idea of how to effectively deliver breaths. I have come to understand that it is easier to demonstrate to the student what they should do. It usually takes a very short time and it is worth it to increase their understanding and confidence. I always reinforce what the video shows them. Sometimes what they see is not best for them. What I do is demonstrate both the video suggested and the alternate way to execute the skill. Usually what I do is explain what the video was showing them and then depending on the circumstances,I might introduce them to another way of doing the same thing. When I show them an alternate method, I urge them to use the one they saw in the video if they can. Many of the students I instruct have small hands. Many come from countries like Indonesia and the Philippines so their hands and fingers are smaller and according to them it is much more difficult and painful for them to use the classic EC clamp technique with the BVM. To make it easier for them I show them how to use the “grasping  the crown”technique(See figure 1)

There is no tension on my wrist or fingers (Placing my fingers over the mask in this fashion pretty much seals it to the face. The rounded bottom portion should not extend below the chin. Then with the mask almost sealed I just reach very gently over the edge of the mask with my fingers (see figure 3↑) With my hand relaxed I extend my fingers and grasp the jaw and pull the jaw and head back and up. When the student grips the chin with their remaining fingers it is easy for them to pull the head back and then deliver an effective breath without causing any strain to their hands or wrists. Many of the students adopt the technique that I show them because they have tried the classic EC technique and have experienced pain in their fingers and wrists from trying to stretch over the mask and press their forefinger and thumb on the edges of the mask and then stretch their other fingers to grab the angle of the jaw on the side and lift the head and jaw back (see figure 4) ↓. Many students cannot do this effectively and when they can’t get chest rise they lose confidence which makes it much more difficult for them to carry out the task of delivering effective breaths. As you can see from the pictures, I grasp the mask at the crown between my thumb and forefinger in the web and then rest my hand on the mask. Once I've done that, then I reach to the chin and pull the head and chin back and up in a gentle sweeping figure 5)

All I have to do is lay my hand on the mask and then extend my fingers to the chin and pull it back as you can see in Figure 5. If the student has extremely small hands or fingers, all they have to do is rotate their hand and thumb around the crown of the mask and then reach with their remaining finger (s) to grasp the jaw and pull it back and up. Whichever fingers can reach the jaw, will be able to pull it up and back. Once the jaw is extended and pulled back it is extremely easy to gently squeeze the bag and make the chest rise. Once the students realize how easy it is, they develop confidence, and their ability to do the task is greatly enhanced. When an emergency presents itself they will be sure of themselves and be able to carry out the task easily and effectively. With them having confidence and demonstrating their skills effectively, both the students and the teacher are happy with the outcome. I am especially happy because many of my students are studying to be EMT’s or Nurses and ride the ambulance as volunteers for my squad. It gives you a real sense of satisfaction when the people you taught are congratulated by other healthcare professionals for the job they did with a patient. It greatly increases their self-esteem and makes me feel good too.