How can you most accurately determine if adequate tidal volume is being delivered to a child during bag-valve mask ventilations?

Monitoring the rise of the chest is the most accurate method for determining if adequate tidal volume is being delivered during bag-valve-mask (BVM) ventilations in a child. When performing BVM ventilation, it is crucial to observe the chest for adequate rise because this visual cue indicates that air is being effectively delivered into the lungs, allowing for alveolar ventilation.

When the chest rises appropriately, it demonstrates that the positive pressure being applied via the BVM is indeed inflating the lungs and facilitating gas exchange. Proper ventilation is vital in pediatric emergencies, as children can quickly deteriorate due to respiratory distress or failure.

Heart rate can change for various reasons and does not specifically indicate whether the ventilations are adequate. Capillary refill is a measure of peripheral perfusion and is not a reliable indicator of ventilation adequacy either. Therefore, observing the chest rise provides the most direct and immediate feedback on the effectiveness of the BVM ventilation being administered.