Successful BVM ventilation requires technical competence and depends on 4 things: A patent airway An adequate mask seal Proper ventilation technique PEEP valve as needed to improve oxygenation Establishing a patent airway for BVM ventilation requires Keeping the oropharynx clear of physical obstructions (eg, tongue, soft palate, secretions, vomitus, foreign bodies) Proper patient positioning and manual maneuvers to relieve tongue and soft tissue obstruction of the upper airway Airway adjuncts such as a nasopharyngeal or oropharyngeal airway to facilitate effective air exchange (see also Airway Establishment and Control) Rapid provision of successful ventilation and oxygenation is the goal.