To provide oxygenation and ventilation before and after suctioning airway procedures and during patient transports

 To assess airway patency and proper airway device placement

 To evaluate the interaction of patient and ventilator

 To alter the ventilatory pattern

 Bagging should result in chest movement and auscultatory evidence of bilateral air entry.

 In patients without an artificial airway in place, effective bagging requires an unobstructed airway, slight head and neck hyperextension (i.e., the same technique used for mouth-to-mouth ventilation), and firm placement of the face mask over the nose and mouth (Fig. 32-1). An exception to this technique is with known or suspected cervical spine injury, in which the patient’s airway is opened with the chin-lift method (without neck hyperextension). Effective bagging is best accomplished with two people: one to secure the mask and ensure head and neck placement and one to bag.¹ In patients with artificial airways, such as endotracheal or nasotracheal tubes or tracheostomies, the nurse must understand the components of artificial airways and their relationship to the upper airway anatomy (see Procedures 1, 2, 3, 7, 8, 9, 12, 13, 14, 18).

 When signs and symptoms of respiratory distress are noted in a patient on mechanical ventilation, the patient should be bagged on 100% oxygen if troubleshooting the ventilator does not immediately solve the problem. Large bagged breaths or rapid rates during bagging may result in dynamic hyperinflation and resultant hypotension.2,3 Hyperinflation occurs when exhalation time is inadequate, which results in auto–positive end-expiratory pressure (auto-PEEP) and decreased venous return (see Procedure 30), with the resultant hypotension. Dynamic hyperinflation is most commonly associated with bronchospasm and chronic obstructive pulmonary disease.² A high index of suspicion for the presence of dynamic hyperinflation is necessary if hypotension occurs with bagging. A brief disconnection from the bag or the provision of longer exhalation times or both results in a rapid increase in blood pressure. Bagging is resumed at a slower rate and with longer expiratory times.