Two-Person Bag-Mask Ventilation Team Roles
During two-person bag-mask ventilation, one rescuer is responsible for maintaining an open airway and sealing the mask to the face using both hands, while the second rescuer squeezes the bag to deliver ventilations. 1
The Two-Rescuer Technique
The 2025 American Heart Association guidelines explicitly define this division of labor:
- First rescuer (airway/seal person): Opens the airway and seals the mask to the face with both hands using a jaw thrust technique
- Second rescuer (bag person): Squeezes the bag during pauses in chest compressions (during 30:2 CPR)
- Both rescuers: Watch for visible chest rise and fall to confirm proper ventilation 1
Why This Matters
Bag-mask ventilation is most effective when provided by 2 trained and experienced rescuers because single-rescuer technique frequently fails due to air leakage between the mask and face or incomplete airway opening. 1 The two-handed mask seal technique with jaw thrust has been proven superior to the one-handed E-C clamp technique. 1
Supporting research confirms this approach can be performed without compromising chest compression quality during cardiac arrest resuscitation. 2 Multiple studies demonstrate that over 50% of emergency medical technicians cannot adequately ventilate using single-rescuer bag-valve-mask technique, reinforcing the critical importance of the two-person approach. 3
Key Technical Points
The two-handed technique allows the airway/seal rescuer to:
- Maintain continuous jaw thrust to keep the airway patent
- Create an effective seal around both the nose and mouth
- Prevent air leakage that commonly occurs with one-handed techniques
The bag-squeezing rescuer (who may also be the chest compressor during CPR) can focus entirely on delivering appropriate tidal volumes (approximately 5-7 mL/kg or 362-406 mL for average adults) without the competing task of maintaining airway patency. 1