If unable to obtain ETCO2 or visualize chest rise during mask ventilation, what should be your next step?

When mask ventilation is ineffective, as indicated by the inability to obtain ETCO2 or visualize chest rise, it is crucial to establish a proper airway in order to deliver adequate ventilation. Placing an oral airway (OAW) can help facilitate better mask ventilation by preventing the tongue from obstructing the airway. This intervention can often improve airflow and assist in achieving chest rise, which is essential for ensuring that the patient is receiving adequate breaths.

In enhanced respiratory support scenarios, appropriate airway management is critical. The oral airway acts as a pathway, improving the likelihood of effective ventilation when using a bag-mask apparatus. If the airway is obstructed, simply increasing supplemental oxygen or manipulating the system without addressing the source of the obstruction may not resolve the issue, and administering muscle relaxants without a secure airway could further complicate the situation without addressing the immediate need for effective ventilation. Therefore, using an oral airway is a sensible step when encountering difficulties in masking ventilation.