What is the best way to determine if adequate tidal volume is being delivered during bag-mask ventilations in a child?

To determine if adequate tidal volume is being delivered during bag-mask ventilations in a child, observing the chest for adequate rise is the most reliable method. When bag-mask ventilations are performed correctly, the movement of air into the lungs causes the chest to rise visibly. This is a direct indicator that the ventilations are effective and that the child is receiving the appropriate volume of air.

Additionally, this method is immediate and allows the rescuer to quickly assess the effectiveness of the ventilations without needing additional equipment. While other methods such as listening for breath sounds, checking pulse oximetry, or measuring end-tidal CO2 can provide valuable information about ventilation and oxygenation, they may not be as immediate or as direct in confirming adequate tidal volume during the process of bag-mask ventilation. For instance, breath sounds can be diminished or absent in certain conditions even when tidal volume is adequate, pulse oximetry results might lag behind the actual ventilation status, and end-tidal CO2 monitoring requires specialized equipment and may not be readily available during an emergency. Thus, observing the chest rise is the most practical and effective way to ensure proper ventilation is occurring.