The ambu bag is used to breathe (bag) for the baby if he/she is not breathing, is having difficulty breathing or when suctioning the baby.
The baby’s airway should be clear of mucus and formula before bagging.
Suction the baby’s mouth and nose with a bulb syringe or with a catheter.
If the baby is not breathing, stimulate the baby to breathe by either flicking the sole of the foot or rubbing the baby’s back or chest vigorously a few seconds. If the baby does not breathe, proceed with bagging the baby.
Place the baby so the tip of his nose is pointed straight up in the air. A small towel or roll under the shoulders may help to keep the baby in this position.
Connect the oxygen tubing to the bag.
Be sure the tubing is connected to the regulator on the oxygen tank
Turn the oxygen on
Set the regulator on a flow of 5-8 liters per minute or a flow ordered by your baby’s doctor.
Place the mask over the baby’s mouth and nose using your hand to hold the mask snugly against the face.
It should not extend over the chin or rest over the baby’s eyes.
Squeeze the bag briskly using your thumb to exert pressure on the bag and fill the baby’s lungs with air/oxygen. You should squeeze the bag hard enough to see the chest rise as if the baby were taking an easy breath.
The rate and length of time to bag the baby depends on the reason for the bagging.
Generally, the rate should be about 20 breaths per minute.
Breathe 1 2 Breathe
Squeeze Pause Pause Squeeze
If the baby is having difficulty breathing, bagging can be continued until the baby begins to breathe normally or until emergency help arrives.
If the baby’s chest does not rise and you have already suctioned the baby, try to exert slightly more pressure on the bag or reposition the face mask on the baby’s face. If the baby’s chest still does not rise:
Turn the baby face down across your arm or face down on your lap, with his head lower than his bottom.
Give 5 brisk back blows with the heel of your hand between the shoulder blades.
Turn the baby onto his back and give 5 chest thrusts (position your fingers like for chest compression).
Look in the baby’s mouth. If you see the object, remove it with your finger. Do not put your finger in his mouth unless you see the object.
Place the baby on his back. Try to give him 2 more slow puffs with the ambu bag or with your mouth to check if the object has moved so that it no longer blocks the airway.
If you still cannot get air into the baby’s lungs, repeat the back blows, chest presses (thrusts), and, again, try to give the baby 2 breaths. (See section on Choking Baby).
Use the bulb syringe to remove any visible mucus or formula. This must be done quickly without panicking!!!
Once the object has been removed, bagging can be continued until the baby begins to breathe normally or until emergency help arrives.