When using a bag-valve mask on a conscious patient with severe respiratory distress, you should:

• A. Ventilate during exhalation
• B. Ventilate during inhalation
• C. Not use the bag-valve mask on conscious patients
• D. Ventilate only after the patient finishes inhaling and exhaling

Answer: (B)

When a bag-valve mask is used on a spontaneously breathing patient, you deliver breaths during the inspiratory phase to augment their own inhalation. Squeezing the bag adds air as they draw air in, helping to increase tidal volume and improve ventilation. Ventilating during exhalation would push air at a time when the lungs are releasing air, which doesn’t assist breathing and can disrupt the patient’s flow and increase pressures. For a conscious patient in severe respiratory distress, you should coordinate each breath with their own inhalation, providing appropriate volume and rate, while maintaining a good mask seal and delivering oxygen. Using a bag-valve mask is appropriate to assist breathing when the patient needs support, not delaying ventilation to after they finish exhaling.