What should you ensure when ventilating an apneic adult with a bag-valve-mask device?

When ventilating an apneic adult with a bag-valve-mask (BVM) device, it is crucial to ensure that an airway adjunct has been inserted. This is important because airway adjuncts, such as oropharyngeal or nasopharyngeal airways, help to maintain the airway patent and facilitate effective ventilation. An airway adjunct reduces the likelihood of the tongue occluding the airway, which can happen when a patient is unconscious and unable to maintain their own airway. The use of an adjunct allows for better seal and ventilation through the BVM, helping to ensure that the air delivered effectively reaches the lungs.

In addition, while it may be beneficial for the patient to be in a certain position or for the mask to be fitted properly, the insertion of an airway adjunct is a primary concern that allows for successful and effective ventilations. If the patient were conscious, the situation would be different, as they could potentially maintain their own airway and not require the BVM, making the consideration of airway adjuncts less critical in that scenario.