Ventilatory support to casualties may be needed in tactical field situations when the casualty is unable to adequately ventilate for themselves, including unconscious patients who are apneic, patients with progressive hypoxic respiratory distress, progressive hypercapnic respiratory distress, and semi-conscious or conscious patients with mental status changes who cannot protect their airway.

The technique for establishing and maintaining a seal with the mask is often called the EC technique, named after the positioning of the fingers on the hand securing the mask, and will be demonstrated in the video. This is also a skill that is taught to Combat Lifesavers, so they can support you, as needed. Once a seal is established, the casualty should be ventilated every 5-6 seconds (10-12 breaths/minute) using a slow steady squeeze over 1-2 seconds.

When ventilatory support is needed, one of the responders must be dedicated to providing ventilatory support, so without support from a Combat Lifesaver or other trained responder the rest of the casualty assessment and treatment cannot be completed. Therefore, it is important to accurately determine if ventilatory support is necessary in order to preserve your limited resources. For example, just because a patient has undergone a cricothyroidotomy does not mean that they cannot ventilate on their own and must be bagged.