Most of us have watched enough TV to know that a clear rubber bag is often put to use helping a medical emergency victim breathe. It seems to be a matter of course to hear, “Bag ‘em and get ‘em to the hospital, stat!” on a favorite cop or medical show. Many of us have no idea, though, what that handy breather is called and exactly how it works, let alone its true purpose, proper use, care, history, etc.
Lots of questions arise about this important medical device. Here is a list of frequently asked questions and answers about the Ambu bag:
An Ambu bag is a medical tool used to force air into the lungs of patients who:
The term “Ambu bag” comes from the acronym for “artificial manual breathing unit” and is used to refer to bag valve masks. The company that invented the Ambu bag was originally called Testa Laboratory and rebranded as Ambu in the 1980s.
The descriptive medical term for an Ambu bag is manual resuscitator or self-inflating bag —most specifically, bag valve mask , or BVM. Ambu bag has become interchangeable with the generic term “bag valve mask,” like Kleenex is a common generic term for a tissue, or Band-Aid is for a small bandage.
A manual resuscitator, or bag valve mask , is a medical tool used to force air into the lungs of patients who:
With the mask pressed over the patient’s airway, air is forced into the lungs by squeezing the bag. The bag then refills itself with air when released, allowing it to return to its original shape. The bag can be squeezed out and re-inflated rapidly and repeatedly to resuscitate the patient and provide oxygen, even if the patient can’t breathe on their own.
When a patient is not breathing or needs assistance to breathe fully, the Ambu bag is used in place of mouth-to-mouth resuscitation. This might happen in situations such as drowning, cardiac arrest, or a drug overdose. Its use requires training, typically to make sure the patient is getting enough oxygen when it is being used.
Other problems which may result in further injury or even death can occur when using the resuscitator, such as damage to the throat, forcing of air into the stomach, etc. While it may look simple to squeeze the bag and help someone breathe, recognizing when and how to use an Ambu bag is actually highly technical and complicated. It should not be attempted by anyone who isn’t fully trained. This training is only provided to first responders and medical professionals.
Note that the mask must seal and the patient’s chest must rise when the bag is squeezed. If this isn’t happening, air isn’t getting into the lungs.
This is an instrument for examining the larynx used for various medical purposes:
An Ambu bag can be connected directly to the trach tube after first removing the face mask. A demonstration video can be found here: How to do CPR on an Adult who has a Trach Tube
The amount of oxygen delivered by an Ambu bag varies, depending on:
Most Ambu bags have a connection port for an oxygen tube which delivers pure oxygen from a cylinder, where the amount of oxygen being supplied can be controlled.
Yes, an Ambu bag can be used without extra oxygen.
An Ambu bag should be used only by trained medical personnel, including doctors, nurses, EMTs and paramedics. Serious complications from misuse of a BVM can occur; it must be used properly for sufficient respiration to be provided and to avoid injuries or complications from misdirection of air, etc. Learn more about BVM usage and complications .
A single-use disposable BVM (bag valve mask) is available for under $20, while reusable units with oxygen reservoir can reach costs over $300.
Some Ambu bags can be cleaned (sterilized) and used repeatedly.
Some Ambu bags are disposable after one use, others are reusable depending on their manufacture.
If an Ambu bag is of the reusable type, it must be disassembled and thoroughly cleaned, first of any “gross soiling” through meticulous hand-rinsing, washing, and re-rinsing. Some Ambu bags can be sterilized in an autoclave at 134° C or 272° F.
Otherwise, it must be sterilized through the use of the recommended disinfectant solution. Glutaraldehyde 2% is an appropriately high-level disinfectant; the bag must be immersed in the solution for at least 20 minutes.
Because of the complicated structure of the Ambu bag, it is recommended that disposable models be used in cases where proper cleaning and sterilization protocols and equipment are not in place.
Life of any Ambu bag depends on its design, what materials it is made from, how it has been cleaned, and in what situations it has been used. Any Ambu bag being reused must be disassembled, thoroughly cleaned and sterilized, then reassembled and tested after each use.
There are three quick checks to make sure an Ambu bag is working properly:
Yes, there are different sizes of Ambu bags, different materials used for disposable vs. reusable bags, and different styles depending on the manufacturer.
Use an Ambu bag to provide two ventilations for every 30 chest compressions. The Ambu bag can be put in place as the first compressions begin.
Laerdal is a maker of Ambu-style bag valve masks, so technically one would refer to a Laerdal bag valve mask. They can be purchased from AED Superstore. You can find a full listing of bag valve masks here .
The Ambu bag was invented in 1953 by German engineer Holger Hesse and his partner, Danish anesthetist Henning Ruben. In 1986, “Ambu” became the name of the company Hesse had started. It began under the name Testa Laboratory in the 1930s, with the invention of a blood hemoglobin test. Many innovations have followed, and the company is still prospering today, with international demand for its emergency resuscitation and medical products.
April 01, 2019 at 10:29 am, Steve Caruso said:
Do ambu-bag masks have a universal fittings among different manufacturers? Or does each manufacturer only accept original factory masks. Question is …are all company’s masks interchangeable??
April 23, 2019 at 10:33 am, AED Superstore said:
Hi Steve – I asked our resident expert and his response was: “Most masks are interchangeable however some have a smaller or larger OD or ID not making them work with other manufacturers. Unfortunately the only way to know for sure is to try.”
July 21, 2019 at 9:43 am, Torre said:
Hi what to do if there is no connecting reservoir bag?is it ok to leave it open or need to cover anything like micropore on the connector of BVM and reservoir? Thank you.
July 23, 2019 at 7:33 am, AED Superstore said:
Hello and thank you for your question. We are unable to give you a solid answer on this one, so we recommend reaching out to Ambu directly. You can contact them through their website at: https://www.ambu.com/contact
September 05, 2019 at 9:19 pm, Sneha said:
If ambu bag is not there in our crash cart what will we use
September 11, 2019 at 1:56 pm, AED Superstore said:
I’m not sure I understand your question completely. You can use any bag-valve-mask (BVM) from any manufacturer. If you mean there is no BVM on the crash cart, you would have to use a CPR mask (if available) or mouth-to-mouth rescue breathing. The simplest answer, however, is to make sure there is a BVM on the crash cart at all times.
September 12, 2019 at 12:43 am, Riva keidar said:
Hi,
Is it Ok to use a BVM connected to a reservoir, WITHOUT any connection to a gas source?
WIll we than achieve the 21% oxygen?
September 17, 2019 at 11:53 am, AED Superstore said:
Hello Riva,
We asked our resident expert and this was his answer:
“In an emergency where a patient is not breathing and its a BVM or no breaths, using a BVM without an oxygen source would be equivalent to mouth to mouth or mouth to mask with a higher concentration of O2 and less CO2 as the device is using room air as opposed to human exhalation.
As far as if it is ok that would be local protocol dependent. As far as the O2 concentration using room air it could be up to 21% oxygen that is delivered but the BVM without being connected to Oxygen will only deliver everything that is in room air.”
October 16, 2019 at 5:26 am, Cathy said:
My home care patient has an ambubag that looks like the mask used to be inflated but is not longer inflated. I don’t see a port or something to reinflate. Does it need to be replaced?
October 16, 2019 at 8:09 am, AED Superstore said:
Please send a photo of the mask to our customer service team at [email protected] and one of our reps will get back to you with an answer. Thanks!
December 10, 2019 at 7:06 am, Bonnie said:
What does the large corrugated tubing around the oxygen tubing do?
December 10, 2019 at 1:45 pm, AED Superstore said:
The corrugated tubing that surrounds the oxygen tubing is there to keep the oxygen tubing from kinking or pinching, which would stop the flow of oxygen to the patient. Thank you for your question and have a nice day!
March 19, 2020 at 5:06 pm, Steve said:
Does oxygen still flow to the patient if the Ambu bag is not squeezed (i.e. is oxygen flowing through the Ambu bag or is there an internal valve preventing the O2 to be expelled until the bag is squeezed)?
April 03, 2020 at 11:34 am, AED Superstore said:
Thank you for your question. We consulted our resident first responder and expert and his response was:
Since the answer depends on the design of the BVM, the manual should be consulted for the specifications and features of the BVM. If you cannot find the answer there, you should contact the manufacturer.
We are sorry we couldn’t be of more help in this area.
March 24, 2020 at 5:15 am, Simranjot said:
Should i feel any pressure against my hand when i have blocked the patient inlet with my palm and squeeze the bag?
April 03, 2020 at 11:34 am, AED Superstore said:
Thank you for your question. We consulted our resident first responder and expert and his response was:
Since the answer depends on the design of the BVM, the manual should be consulted for the specifications and features of the BVM. If you cannot find the answer there, you should contact the manufacturer.
We are sorry we couldn’t be of more help in this area.
March 25, 2020 at 1:36 pm, Jorge said:
How many compressions can an ambu bag last?
I’m from south america, we are trying to create an automatic ventilator using an ambu bag, a question that arises is how many compressions can it last for, this will determine the durability of the ventilator, and if it’s necessary to change it every so often.
April 02, 2020 at 1:40 pm, AED Superstore said:
Interesting question, given current happenings we can see the mindset behind this.
We do not have the answer, unfortunately. Our best suggestion would be to reach out to the manufacturer and pose this question. You should ask if they know how many times the bag can be squeezed before it fails. They may or may not divulge that answer but it’s worth a shot to ask.
March 28, 2020 at 4:46 pm, Jesse said:
What is approximate number of “squeeze cycles” these BVM’s are good for? Is there any data or references on this?
April 03, 2020 at 7:05 am, AED Superstore said:
We do not have an data on the number of squeeze cycles. We recommend you contact the manufacturer and ask them how many times the bag can be squeezed before it fails.
March 30, 2020 at 8:49 pm, A California rocket-maker will start producing simple ventilators - Techio said:
[…] “bridge” ventilators in the coming weeks. These are simpler devices, akin to the handheld “ambu” bags used by paramedics to give oxygen to patients over brief periods of time, while in transit or […]
March 30, 2020 at 9:11 pm, A California rocket-maker will start producing simple ventilators - Non Perele - News Online said:
[…] “bridge” ventilators in the coming weeks. These are simpler devices, akin to the handheld “ambu” bags used by paramedics to give oxygen to patients over brief periods of time, while in transit or […]
March 30, 2020 at 9:25 pm, Virgin Orbit will build ventilators to fight coronavirus — Quartz – All Sides Now said:
[…] “bridge” ventilators in the coming weeks. These are simpler devices, akin to the handheld “ambu” bags used by paramedics to give oxygen to patients over brief periods of time, while in transit or […]
April 01, 2020 at 5:59 am, fearful said:
to reduce exposure to coronavirus, is it recommended to put a peep valve on the exhalation side? how much exposure comes out the exhalation side? thanks
April 02, 2020 at 1:34 pm, AED Superstore said:
Thank you for your question. Altering the BVM outside of manufacturers recommendations is not recommended.
Proper PPE should always be worn to limit exposure to COVID-19.
April 01, 2020 at 8:39 am, s rubin said:
How hard does one have to squeeze the bag?
April 03, 2020 at 11:32 am, AED Superstore said:
Thank you for your question. We put it to our resident first responder and this was his response:
A BVM should be squeezed in a controlled fashion to deliver enough air to see the patient’s chest rise. Each breath should be given over about 1 second to avoid hyperventilation.
April 04, 2020 at 3:17 am, Nahom said:
Hi there, I want to know how the air exhaled by the patient is cleared while using the ambu bag? Does it go into the ambu bag or goes out in another direction? And how does the ambu bag filter the air from dust and other particles in the atmosphere?
Thank you.
May 04, 2020 at 9:01 am, AED Superstore said:
The BVM (bag valve mask) has a one-way filter. It allows air to be inspired into the lungs and upon expiration, the airflow is expelled away from the patient by way of an outflow diverter valve which pushes the outflow through the exhalation port, which is just above where the mask attaches.
There is no filter for the environmental air conditions. However, everyone else in the area would be breathing the same air. If the air quality is hazardous to everyone it would be advisable to move the patient and everyone else to the nearest safe location as soon as possible.
April 05, 2020 at 6:39 pm, Clinton said:
I’m curious how much pressure is required to squeeze the ambu bag.
May 04, 2020 at 9:08 am, AED Superstore said:
While there is no document we could find showing the pressure required to squeeze a bag, “the bag is highly responsive with minimal mechanical resistance.” Basicaly, not much more pressure than it takes to make a fist.
April 09, 2020 at 7:15 pm, J. Andersen said:
What does the bag do with the CO2?
May 04, 2020 at 8:57 am, AED Superstore said:
The BVM (bag valve mask) has a one-way filter. It allows air to be inspired into the lungs and upon expiration, the airflow is expelled away from the patient by way of an outflow diverter valve which pushes the outflow through the exhalation port, which is just above where the mask attaches.
April 20, 2020 at 8:56 am, Anjy Tichenor said:
Is a ambu bag typically productive over compressions if there is a obstruction such as mucous plugs and the idividual has a weak pulse but isnt breathing?
April 20, 2020 at 12:20 pm, AED Superstore said:
Our resident specialist had this answer to your question:
BVM’s are very effective in delivering ventilations in patients that require assisted ventilation. If there is an obstruction in the airways the BVM may not deliver as effective of a breath and the obstruction would still need to be addressed as per protocol or training dictates.
May 06, 2020 at 8:04 am, Mohamed Nasser said:
IS the volume of pumped air the same as normal tidal volume ?
Are ventelation ratesthe same as respiratort rate of normal person ?
volume and capacity of ambu bag ?
September 30, 2020 at 1:06 pm, AED Superstore said:
The volume capacity for a BVM can be greater than normal tidal volume and BVM ventilations should be titrated to enough volume to ensure the chest rises. Volume beyond the chest rise could result in over ventilation and unnecessary gastric distension. Ventilation rates can vary by local protocol, but the AHA recommends 1 breath every 6 seconds or 10 breaths per minute. Volume and capacity can vary BVM to BVM. If you would like specific information, please feel free to contact our customer care team at 800-544-0048.
July 20, 2020 at 5:36 am, Stephanie Rossi said:
Does the temperature of the storage room affect the integrity of the face mask? I am asking because I found many of our face masks not only deflated but they became sticky. It also happened with our non-rebreather masks. Given the current climate with COVID-19, I hate to throw out medical supplies. The room we currently have them in gets very hot at humid at times.
September 30, 2020 at 1:05 pm, AED Superstore said:
Yes, the temperature can impact the performance of these supplies. We recommend following the manufacturer’s guidelines for storage temperature as well as what to do in the event equipment has been stored outside of the recommended temperature range.
August 28, 2020 at 12:46 pm, Shana Fleishman said:
If an Ambu bag is used on me, can it leave me with a sore throat afterwards?
September 01, 2020 at 11:04 am, AED Superstore said:
Anytime manual ventilations are performed it can cause irritation in the oropharynx which can cause a sore throat, especially if an advanced airway device like an ET, King airway, etc are used.
September 15, 2020 at 7:06 pm, Christina said:
Say there is no oxygen hookup or tanks or flow of any kind. Would using an Ambu bag still provide any benefit during an OD for example with a patient still not breathing? I’d assume yes as you’re just forcing room air into their lungs. But even without any flow of any kind?
September 30, 2020 at 1:03 pm, AED Superstore said:
Thank you for your question. In the event of respiratory arrest where a BVM is available without oxygen, it can be used to deliver emergency ventilation. Supplemental Oxygen should be connected as soon as possible.
September 29, 2020 at 4:52 pm, Annette Margaret Anderson said:
Can someone direct me to any publications looking at the difference between using a demand resucitaire vs AMBU bag. I am a trainer and have come across some clubs where I am training in the future and they only have this and dont carry AMBU bags. I can see the Demand Resucitaire now prevents overinflationand only will give 40l pm but Iwould like to see something that has looked at the differences. That would be great i anyone has any ideas
September 30, 2020 at 9:36 am, AED Superstore said:
Thank you for your question. There is some research out there comparing powered ventilation devices against manual ventilation devices and the opinions and findings differ greatly. Unfortunately, we are not qualified enough to provide an answer on which findings would be correct, so we can not make a recommendation on which information to implement.
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January 02, 2021 at 12:52 am, katrina said:
is there a need to have a regular function test for disposable ambubag?
January 04, 2021 at 1:29 pm, AED Superstore said:
Thank you for your question. Function tests can be performed on single-use BVM’s. Each manufacturer has slight variances in how the test is performed. The frequency and or direction to perform a function test is generally specified by local facility policy. We are happy to provide function test procedures for the BVM’s that you have.
April 14, 2021 at 8:11 am, Kathy said:
When performing CPR, and you have available both an oxygen tank and an oxygen concentrator, which should you choose to hook up to the AMBU bag?
April 14, 2021 at 9:33 am, AED Superstore said:
Hi Kathy – Our resident expert has this advice:
So…… Many schools of thought on this one but I am going to stick to facts.
The preferred source of oxygen while delivering breaths via BVM would be an oxygen tank in order to control and have the ability to deliver a higher concentration of Oxygen during manual ventilation, however if a concentrator is all that is available at the highest setting (5-8LPM) the concentrator could deliver a marginally higher concentration of oxygen as compared to room air.
August 06, 2021 at 4:03 am, Tasin Zaman said:
Using BVM without oxygen cylinder how much air/O2 pressure (maximum and minimum) should we give to a COVID-19 patient according to their age??
August 06, 2021 at 7:13 am, AED Superstore said:
I’m sorry, but we are not qualified to give medical advice. Please check with the manufacturer or local hospital for the answer. Thank you.
August 12, 2021 at 8:01 am, Watching My Son Be Hospitalized With Pneumonia Is Traumatizing said:
[…] the 40% range. The next thing I knew, doctors and nurses were swarming the room. I watched as they bagged my son to help him breathe, but it barely helped. I immediately broke down and […]
August 16, 2021 at 2:03 pm, Lavita said:
During CPR when we giving breaths to the patient through ambu bag whether we should connect oxygen tube to ambubag or without oxygen connection oxygen tube to the ambubag we can give breaths through ambu bag
August 16, 2021 at 2:28 pm, AED Superstore said:
Hi Lavita,
We can’t give medical advice on use of our products, so we recommend reaching out the manufacturer with your question to get the best use answer. Thank you.
March 22, 2024 at 3:38 am, renimol alex said:
Does ambu bag to be replaced after expiry date eventhough this was never used it. If so who provides this
May 07, 2024 at 12:47 pm, AEDSuperstore said:
Yes, it’s recommended to replace medical equipment such as an Ambu bag after its expiry date, regardless of whether it has been used or not. The expiry date is there to ensure the safety and effectiveness of the device. Even if it appears to be in good condition, materials can degrade over time, potentially compromising its functionality when needed. As for who provides replacement Ambu bags, please contact our team at [email protected] and our team members will be happy to assist you.
