A pocket mask is a specialized barrier device designed to facilitate mouth-to-mask ventilation during cardiopulmonary resuscitation (CPR) or rescue breathing. This transparent, portable tool establishes a hygienic seal over the victim’s mouth and nose, protecting the rescuer from direct contact with the victim’s breath and bodily fluids. The mask enables the effective delivery of air into the victim’s lungs while minimizing the risk of cross-contamination. Using this device allows a single rescuer to maintain an open airway and a tight seal simultaneously, improving ventilation efficiency.
Pocket Mask Components and Pre-Use Checks
The pocket mask is composed of a flexible, clear dome that conforms to the face and a one-way valve assembly that attaches to the center. The transparent material allows the rescuer to monitor the victim’s mouth for secretions or vomit, and to observe chest rise during breath delivery. The one-way valve permits the rescuer’s exhaled air to enter the victim but prevents the victim’s exhaled air from flowing back toward the rescuer.
Before use, the mask requires a quick preparatory check. The flexible dome should be fully pushed out from its collapsed storage state to achieve the correct shape for sealing. Confirm that the one-way valve is securely attached to the port in the mask’s center. Some models feature an auxiliary oxygen inlet port, which should be checked if supplemental oxygen is available. Inspect the mask for any visible damage, tears, or contamination that could compromise the seal or barrier integrity before placing it on the victim.
Step-by-Step Procedure for Adult Rescue Breathing
Effective use of the pocket mask begins with ensuring the victim is lying flat on their back on a firm surface. The rescuer first opens the airway using the head-tilt/chin-lift maneuver. This involves placing one hand on the victim’s forehead and two fingers of the other hand under the bony part of the chin. Applying gentle pressure tilts the head back, lifting the chin forward to move the tongue away from the back of the throat and clear the airway.
With the airway open, the rescuer positions themselves at the victim’s head and places the mask over the face. Ensure the pointed end is over the bridge of the nose and the wide end covers the mouth and chin. Achieving a tight, leak-proof seal is important for successful ventilation, accomplished using the E-C clamp technique. The thumb and index finger of the hand closest to the mask form a “C” shape, pressing down firmly onto the dome’s rim to secure the top half of the seal.
The remaining three fingers of that same hand form an “E” shape, hooking under the bony angle of the victim’s jaw. These fingers provide upward pull, helping to maintain the head-tilt/chin-lift position while drawing the jaw up into the mask to complete the seal. The rescuer then takes a normal breath and places their mouth over the one-way valve opening. Air is delivered steadily over approximately one second, watching the victim’s chest to confirm a visible rise, indicating successful lung inflation.
Deliver only enough air to make the chest rise, as excessive force can push air into the stomach, potentially causing regurgitation. After the chest rises, the rescuer removes their mouth from the valve to allow the victim to passively exhale, maintaining the tight E-C clamp seal. For an adult with a pulse but not breathing, maintain a ventilation rate of one breath every five to six seconds. If the initial breath does not cause the chest to rise, immediately reposition the head and neck, re-establish the seal, and attempt a second breath.
Adapting Technique for Infants and Children
When using an adult pocket mask on a child or infant, specific adjustments are necessary to accommodate the smaller size and different anatomy. For children, the head-tilt/chin-lift should be less exaggerated than for an adult to avoid closing off the softer airway structures. The preferred position is a “sniffing position,” where the head is only slightly extended, aligning the airway for optimal air flow.
Sealing the mask over a small face requires focusing on firm but gentle pressure to avoid compressing the soft tissues of the throat, though the general E-C clamp principle still applies. If a standard adult mask is the only device available, it may be necessary to invert the mask so the narrow end sits under the chin for a better fit over the nose and mouth. The primary adaptation is controlling the volume and force of the delivered breaths.
Infants and children require smaller, gentler puffs of air, delivered slowly over one second, confirming only a slight, visible chest rise. The delivery must be controlled to prevent over-inflation of the smaller lungs. For a child with a pulse but not breathing, the ventilation rate is one breath every three to five seconds.