Manual bag valve mask ventilation performance among respiratory therapists

•Respiratory Therapists ventilated manikins at high pressures via bag valve mask (BVM) ventilation.•Respiratory Therapists with more experience and higher confidence levels ventilated at unsafe peak pressures and flow rates.•There is urgent need for interventions to address safe BVM practices. High peak pressures delivered via bag valve mask (BVM) can be dangerous for patients. To examine manual ventilation performance among respiratory therapists (RTs) in a simulation model. Respiratory therapists (n=98) were instructed to ventilate a manikin for 18 breaths. Linear regression was utilized to determine associated predictors with the outcomes: delivered tidal volume, pressure and flow rate. Among all participants, the mean ventilation parameters include a tidal volume of 599.70 ml, peak pressure of 26.35 cmH2O, and flow rate of 77.20 l/min. Higher confidence values were positively associated with delivered peak pressure (p=0.01) and flow rate (p=0.008). Those with the most confidence in using the BVM actually delivered higher peak pressures and flow rates compared to those with lower confidence levels. Our results emphasize the urgent need to create an intervention that allows providers to deliver safe and optimal manual ventilation.