When ventilating with a bag-valve mask, which is a potential complication?

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When ventilating with a bag-valve mask, forceful ventilation can cause barotrauma. Pushing breaths too hard or delivering them at high pressures can rupture small air spaces in the lungs, leading to pneumothorax or other air leaks (pneumomediastinum, subcutaneous emphysema). This is why the goal is to deliver adequate tidal volumes that produce visible chest rise without overinflating the lungs, and to use controlled, measured breaths rather than rapid, forceful forcing. Proper technique—monitoring chest rise, using an appropriate rate, and ensuring a good seal (often with a two-person team to optimize control)—helps minimize pressure and reduce risk.

It's important to recognize that while BVM is essential for providing ventilation, it does carry risks. Hyperventilation can occur if breaths are delivered too quickly or with too large a volume, and gastric insufflation is another potential complication from excessive force. Additionally, a BVM is not limited to patients who are spontaneously breathing; it’s used for apneic or inadequately ventilating patients as well.