Suicide/Suffocation/Helium

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The helium suicide method has been used widely, including reportedly by reputable
organisations like Dignitas. (Dignitas now uses only a drink of 15 grams of pentobarbital
sodium: trade name Nembutal). The helium method is based on the fact that breathing inert gas
like helium does not produce any feeling of suffocation, but depletes the body of oxygen, leading
to loss of consciousness and death.
Compared to other methods:

All parts (helium tank, plastic tubing etc) can be legally bought and
possessed.Template:Pluspoint stop
Can be done at home,in one's own convenience.Template:Pluspoint stop
Does not put others at risk.Template:Pluspoint stop
Complete setup requires significant amount of handwork.
Some people find having plastic bags over their heads disgusting.
One must be very accurate in technically applying the method in order to succeed.

Contents
[hide]

1 How to generally use it (specific instructions are given later on)

2 Experiment with animals

3 Cause of death

4 THE METHOD
o 4.1 Equipment
o 4.2 Lethal dose

o 4.3 Sleeping pill

o 4.4 How to adjust the hose to the tank and "make the set"
o 4.5 What if you buy the tank from other sources?
o 4.6 The stepwise guide
o 4.7 Statistics and case reports

5 If using a T-connector instead of a flow regulator

6 Time of death info

7 Reports of failures:analysis of the causes,and insights of how to avoid it

o 7.1 Report on failure - #1
o 7.2 Report of a failure - #2
o 7.3 Report of a failure - #3
o 7.4 Report of a failure - #4
o 7.5 Report of a failure - #5
o 7.6 Report of a failure - #6

8 FAQ and common discussions

o 8.1 Calculations
o 8.2 Which purity of helium is needed?
o 8.3 But if the helium runs out wouldn't I suffocate?
o 8.4 Q: How is removing CO2 going to kill you?
o 8.5 Q: What final exit says and what's missing there?
o 8.6 Q: Some issues which may arise when buying the balloon kit tank?
o 8.7 Q: what is most important to take care of before pulling the bag over the
head?

9 References

How to generally use it (specific instructions are given later on)[edit]

Probably the easiest way to use inert gases for suicide is to enter a tube tent with a gas cylinder,
flush the tent with any of the three gases, and seal the ends of the tube. The volume of a tent is
such that you won't produce enough carbon dioxide to stimulate breathing reflexes before dying.
Since there's little or no residual oxygen in the breathing mixture, minimal amounts of carbon
dioxide ought to be exhaled, suggesting that a large inert gas-filled plastic bag over the head
should work as well as the tube tent.

Experiment with animals[edit]

In experiments, animals (dogs, cats, rabbits, mink, chickens) show little or no evidence of
distress from inert gas asphyxia, become unconscious after one to two minutes, and die after
about three to five minutes. Thus, use of any of these three gases, combined with a plastic bag,
should be less traumatic than plastic bag asphyxia alone, since there will be little discomfort
from carbon dioxide buildup and unconsciousness will be swift.

Cause of death[edit]
Inhalation of 100% pure helium (which is not mixed with oxygen) causes rapid death due to
oxygen deprivation (since the helium displace the oxygen).when breathing pure helium inside a
plastic bag, unconsciousness follows after about 5 breaths. In 62 cases where "time to
unconsciousness" was reported, the average was 35 seconds (range 10-120 seconds). Death will
often follow in about 10 minutes, sometimes as quickly as 5 minutes. Elapsed "time to death"
was reported in 108 cases. The average was 13 minutes (range was 2 to 40 minutes).

THE METHOD[edit]
Equipment[edit]
At least one organization sells a helium suicide kit. Tanks of helium can be purchased from toy
stores.

Lethal dose[edit]
According to the book Guide to a Humane Self-Chosen Death written by Dr. Pieter Admiraal and
a committee of medical professionals, nearly in all 119 reported cases used non-refillable party
balloon kits. A small tank [4.5 cu ft] is sufficient to bring about death if breathed in a plastic bag.
To be sure, I would go for 8.9 cu ft [the following size].the assumptions are that the tank is new
and full, and that there are no leaks in the bag.

Sleeping pill[edit]

The book Final exit recommended taking few Valiums to contract convulsions and so; however,
Dr. Admiraal from the Dutch euthanasia group says in his book that: "to be sure that one does not
make any errors in the procedure, pills are not recommended". I tend to agree here with the
Dutch booklet, since, falling into any sleep, may indeed cause you to act out of shallow or deep
sleep, while you may take off the bag or miss some details. Case Reports regarding sleeping pills
with helium in 31 reported cases, the patient took no meds at all. no complications were reported
and time to death was not influenced.
The needed items:
1. Helium tank.8.9 cu ft or more
2. Oven roasting bag (19x24 Inch =45x60cm)
3. Soft plastic hose/tubing 3 meters. The tubing must fit snugly over the tank nozzle. For
most party balloon kits it requires tubing with an inner diameter of 3/8 or 5/16 inch
4. A rubber band such as of tennis players

How to adjust the hose to the tank and "make the set"[edit]
1. Take off the plastic nozzle of the tank. (Use any type of pliers for this. You can also do it
carefully with a carpet knife if you have trouble finding out what type of plier to use).
2. Put the edge of the plastic pipe in warm water for some minutes to make it softer.
3. Connect the hose to the tank and make sure it is very well adjusted. Use a half inch hose clamp
(you can get it in hardware stores) and adjust it with a screwdriver. If you're using a "Y"-tube for
two tanks, remember to take the tube through the clamp before fitting the tube to the tank (if the
clamp can't be opened).
4. Check the bag for holes or leaks. If you blow it with air you would be able to check in case it
leaks.

What if you buy the tank from other sources?[edit]

If you buy directly from a helium supplier, you should buy a regulator from them as well in order
to control the gas flow. Never buy other than a new tank of helium, since you can never know
otherwise if the tank is full. It is advisable by the Dutch euthanasia group to practice the
procedure without helium so that you make sure you know exactly how to do it.
Note that testing is problematic; if you get one of the consumer helium tanks, you will most
likely have a nozzle that won't shut completely, so if you perform a test of helium output with
such a tank, you might eventually lose all of the helium before your actual exit date. However, a
helium tank from a commercial helium supplier should not have this problem.

The stepwise guide[edit]

1. The position: you have to sit or lean, such that your body is vertical, since the helium tends to
rise.
2. Open the valve and close it immediately. That's for the first opening of the tank.
3. Place the bag on your head such that the margins of the bag cover only the ears and your
forehead.
4. Now, the most important thing is to get the air out of the bag. If you have air there, you won't
lose consciousness quickly. Most literature recommends doing it by squeezing the bag with both
hands on your head to deplete the air. However, I suggest that this way there is a good option that
air would be present.
Alternatively, you can simply put the bag on a flat surface, roll it back and forth to get all the air
out and then you may close it tight, while leaving long enough margins (after the place where
you close the bag with your hand tight), for placing the bag with the band, back on your forehead
and ears. By doing so, you are more likely to get rid of all the air.
5. Now, open the valve and let the bag inflate with helium. You should now be prepared to pull
the margins of the bag with the band over your head. The rubber should not be too tight since
you need to leave some room for the CO2 you exhale, to get out of the bag through the bottom.
6. Now,VERY IMPORTANT: The Dutch group recommends here, to exhale all the air in your
lungs BEFORE pulling the bag over your head. There is logic here, since you need to get rid of
all CO2 in your lungs. So you need now to make a big exhalation, then hold your breath, pull the
inflated bag over your head with the band, and now, you should take a very deep breath(of the
Helium in this inflated bag), when inside the bag.
7. Continue to breathe normally, unconsciousness should follow quite quickly.

Statistics and case reports[edit]

According to Pieter Admiraal's book, in 119 reported successful cases using helium and a plastic
bag: Nearly all cases used a non-refillable balloon kit, although, it is less reliable than any
industrial size tank. In 62 cases where "time to unconsciousness" was measured and reported by
an eyewitness, the average was 35 seconds [10-120 range] in cases where it took longer than
average, it was reported that there were difficulties with gas flow, Leaking tube/nozzle
connections, or improper seal between the neck and the bag. That's why a good preparation is
needed, says the Dutch group.

If using a T-connector instead of a flow regulator[edit]

If using a T-shaped connector to join the flow of two disposable helium tanks, make sure to use
one made of PLASTIC or VINYL. A T-connector is often sold as a "hose barb" or a "garden hose

tee". The right size (if using tubing of 1/2" OD and 1/8" ID) is 1/8" OD so the tubing will fit
OVER the T-connector perfectly. T-connectors look something like this:
http://i.imgur.com/piqQo.jpg. Often sold in the PVC isle of a hardware store.

Time of death info[edit]

Time to death was reported in 108 cases --- the average was 13 minutes [range 2-40 minutes].
Muscle contractions were reported in half the case reports. it happened between 2 to 8 minutes
into the procedure. Arms and legs will tighten and relax few times for about 10seconds to 2
minutes duration. It is not should be interpreted as an attempt to remove the bag. Those
contractions are common in anesthesia in surgery settings. Witnesses of several cases with
helium said that they have never seen a case in which the hands reached the plastic bag. Patient
is unconscious in this stage. Deep gasps are common in the unconscious stage. In 31 cases in
which no meds were in used it was found that there is no correlation between meds and
contractions. In 11 cases contraction have been present while in 7 non were present.

Reports of failures:analysis of the causes,and insights of how

to avoid it[edit]
Report on failure - #1[edit]
Source: this ASM thread
"Speaking from experience, I can say that helium is not as comfortable as it sounds. Breathing it
was not a problem. However, moments after beginning, my whole body started feeling all tingly
(like a foot that has fallen asleep or something). After that, body started having uncontrollable
convulsions. Finally reached up and removed the plastic bag. I was a bright shade of pink for a
while after the experience, which I found out later, was a symptom of oxygen deprivation. Was
no pain, just a very uncomfortable feeling "
Explanations: What might have happened?
The man describes what he has done: "What I had done, was place the bag over my whole
head/face, ran the hoses up into it, pulled the rubber band down around my neck, and held the
rubber bands away from my neck to continue breathing air until I was ready."
Mistakes done: That means he had a good breath of air in his lungs when went went in (as he
DID NOT exhale first as he should, in order to deplete the lungs from CO2). Moreover -- there
was probably quite a bit of oxygen in the bag as well, since the man did not emptied the bag
BEFORE streaming helium in.
General inferences, following that case:

The main goal when using an inert gas, is to have a sudden and intense exposure to the gas. You
need to make the best you can to make sure that no oxygen or carbon dioxide is in there to
contaminate the helium, with your first few intakes of breath you will be inhaling nearly-pure
helium. This is what is required for a quick loss of consciousness. if you proceed by piping
helium into a bag (or tent) which currently contains air, that would be quite disastrous -- for a
long time there would be enough oxygen to support consciousness, and that consciousness would
become very unpleasant before it vanished.

Report of a failure - #2[edit]

Quote: "I really tried the helium method as described in the Dutch booklet, and really wanted to
go. Before dragging the bag on my head I was even excited and happy that finally all my misery
and illness will be history. So with the full of helium bag on my head I started to breathe
normally waiting to lose consciousness in 2-5 breaths. Instead of that, after some 15 deep breaths
of helium all I felt was pain in my chest, my heart pounding like hell and a HUGE panic. It was
everything but pleasant or peaceful. So, I couldn't resist those overwhelming feelings and took
the thing off. It took some 10 mins. to get back completely. I felt dizzy and had a light headache.
I was hoping I didn't damage my brain. What I want to emphasize for you is that this method is
not so peaceful as I would have thought."
Explanations: What might have happened?
I knew of one other person who did not lose consciousness quickly and who felt significant panic
(enough to make her stop). In her case I think it may have been because the helium was
contaminated with oxygen-containing room air. She wanted to use 3 tanks, to be sure that the
helium would not run out too soon, but she joined the various tubing pieces with T-connectors
intended for use with copper plumbing pipe. These connectors went on the outside of the tubing
rather than on the inside (she had not managed to find the kind that goes inside the tubing, and
the hardware-store person told her that the plumbing connectors would be just as good). She put
lots of tape over each place where a connector lay over the tubing, but she used electrical tape,
which does not have a high degree of stickiness (not as high as duct tape, for instance). There
were quite a few of these possibly-leaky connections, and I think that perhaps wherever the
helium flowed past a connection it (pulled in) some room air.
Also, this above person may have skipped thoroughly forcing all room air out of the bag before
filling it with helium, and thoroughly evacuating the lungs by doing a big "Whoof!" immediately
before pulling the bag down.
If the first thing is not done, there can be quite a bit of oxygen left in the bag, and if the second
thing is not done, there can be quite a bit of carbon dioxide. Breathing carbon dioxide causes
panic. However, panic can accompany rapid loss of consciousness even in the (relative) absence
of carbon dioxide (I felt it when I passed out from ether, though only for a couple of seconds).

Report of a failure - #3[edit]

Source: | this message 11-8-2006

"I recently tried the helium + plastic bag, and I failed. I bought a 20 l helium tank and some big
plastic trash bags. The first problem I experienced was that the tank was huge. And I didn't have
any tube to connect it to the bag. So I tried a few methods. I first tried lying in bed (slightly
upwards so that the helium would concentrate at the top) and had the top part of the tank inside
the bag along with my upper body. I closed the bottom part of the bag pretty well to prevent
leakage. I had the helium tank running for a little while and my head started to get dizzy, but
quickly panic stepped in. I tried to wait it out, but in the end I just couldn't. Anyway, I thought
maybe the bag was too contaminated with oxygen, and that's why I kept getting the panic attacks
(quick heartbeat etc). So I tried to fill the bag with helium before I actually put it over my head.
Then I put it over my head ... same result, although, it lasted longer in that attempt, probably
because there was less helium in the bag. I tried a few different postures with the bag over my
head and the tank inside, but nothing seemed to work. At the end I was feeling very dizzy, but I
just couldn't go through with it. Could anyone give me some advice? I thought this method was
supposed to be foolproof and painless, but it just wasn't for me. I felt the same way that I feel
when I put a plastic bag over my head and no helium, the panic and increased heart rate steps in
pretty quick."
Explanations: What might have happened?
Template:Horizontal rule
When somebody does not lose conscious shortly, it is due to excess of oxygen in the bag. It
usually happen when the bag is not previously completely depleted out of all the air. That should
be done before any helium is blown into the bag. Residual oxygen will make you experience the
side effects. Now, as to the panic itself, I would attribute it to a CO2 build up. One should not
complexly close the marginal of the bag, and only use a slightly tightened band, to let the CO2
escape from the bottom. During the first attempt, this guy got into a kind of a "tent". This
imposes a problem since you have large amount of oxygen there, and you need to either deplete
it first, or to create a very strong and steady stream for that.

Report of a failure - #4[edit]

Source: An ASM message in this thread
Oct. 2004 "I tried this recently. I panicked while nearly passed out and took the bag off, although
I only vaguely remember doing it. I used a tank with 15 cubic feet of helium. In the U.S. (at least
here in California) you can get these at Party stores. So be sure you take something to relax you
or make you sleepy, and be sure that the helium is turned up high enough to keep the bag from
getting warm and moist and hitting your face, which is what caused my state of panic. You will
start breathing heavily as your body starves for oxygen. I suspect if I'd been in there another 15
seconds I would not have been able to undo it."
Explanations: What might have happened?

14.9 cu ft of helium should be well sufficient for succeeding. While Final Exit recommends 1-2
tanks of 9 cu. feet, it was proven that even 4.9 cu ft should be enough. moreover, the Dutch
euthanasia group, recommended, following more than 120 case reports, to avoid using more than
one tank, since there is a great chance that the connectors would create a leak, if you use more
than one tank. It is indeed recommended to make sure the regulator of the tank is at least turned
to a one third [full guide is given] to allow sufficient flow of helium. However, using sedatives is
not recommended in this method as it may increase the chances to fail, as you are likely to miss
some of the accurate instructions if so. The moist and heat in the bag should be prevented once
you open the valve sufficiently as instructed.

Report of a failure - #5[edit]

July 2007, a report of M.D. :
"In the one case of which I have knowledge, there were many difficulties. The size of the tube
that was given did not fit the fixture and, at the last moment, had to be reamed out with a
makeshift tool. The valve was very hard to open and knuckles were slashed on the sharp handle
of the tank as the struggle to open it ensued.
"The patient appeared to fall asleep readily and in seconds, but after about a minute eyes opened
and the patient sat up slightly and breathed shallowly and extremely rapidly (over 200/minute)
for ten to fifteen seconds. This occurred three times. After that, both upper and lower extremities
flailed about for fifteen seconds or so. Then, after a few minutes pause, this happened again.
Then once again, the movements did not conform to any pattern. The eyes were partially open
and it could not be determined if there was any consciousness.
"The whole process took about fifteen minutes and was horrifying to the onlooker. The person
who had given the verbal instructions for the procedure thought it might be due to the fact that
the patient was, due to chronic respiratory difficulty, unable to take a deep breath and exhale at
the right moment, but subsequent discussions with anesthesiologists cast great doubt on this
notion as total anoxia must have occurred long before much of the seizure like behavior even if
not quite as quickly as with a good exhalation. Also, the question was raised if the pacemakerdefibrillator had produced some of the effects, but discussions with cardiologists tended to rule
that out as the amount of current was deemed to be too low to produce seizure. Apparently, from
some of the current mailings, the helium Method is not the ideal exit that it's touted to be.
Norman J Ackerman, M.D."
Explanations: What might have happened?
The first part can easily be dismissed as not ensuring everything would go off without a hitch,
but the actual account of it seems disturbing. I know, I shouldn't be surprised it's not a party, but
still.
I might be wrong, but this seems to lead to only one conclusion, that oxygen was leaping in from
somewhere.

That seizures during the process are likely to occur seems to be inevitable, the question is, is the
person aware of them or in any pain, when it happens (patient should be unconscious in that
point)?
If a mask has been used it tends to be less effective in this method. The origin of the helium is
another factor which may be missing.

Report of a failure - #6[edit]

Source: | ASM message
"I failed with helium today. I never passed out; I just got light headed and experienced tingling
and numbness in my hands/arms. What I used: 99% Pure helium 14.9 cubic feet tank > tube >
plastic bag 2ft x 7 ft non- rebreathable medical mask > tube ----------^
"I should have had enough helium pumping into that bag to do the job but I am still here and I
never passed out so something went wrong. My best guess is either (despite the amount of tape I
used) there was a leak somewhere on the bag (does helium escape particularly easily?), or the
mask wasn't doing its job properly and letting air in. Can anyone help me out with ideas of how
to make this work? I have thought about a small tent but after this failed attempt I have a feeling
the helium would escape extremely easily. I can't just do it straight from the tank to a mask
because there isn't enough helium, I need to contain the helium in something and make sure I
waste as little of it as possible. A regular plastic bag over my head wouldn't hold enough either."
Explanations: What might have happened?
Indeed, helium "escapes" quite quickly in any open space or such as not sealed well enough.
Thus any possible leak, either in the tube or in any mask or so, may be a reason for such a
failure. In addition, again, the man has not lost conscious, probably due to remnants of oxygen
penetrating to the mask. That's why I would say a closed chamber would be better. [for this term,
a plastic bag would be considered as a chamber of course]
Suggestion: I've heard people purchased the party balloon tanks only to find out when they got
them home that the package had already been opened, and when used, found it to be empty. The
problem here maybe returned tanks going back on the shelves. So check the package to see its
been opened before, make sure its in a sealed box! You could also do a one balloon test. Tell the
store you are purchasing it but want to make sure its not leaking, with permission open the valve,
blow up one baloon.. if it fills quickly its working the way it should, tanks with leaks would fill a
balloon slowly. Tighten the valve very tight once you are through.

FAQ and common discussions[edit]

Calculations[edit]
An average person will breathe in and out about 12 to 20 times a minute [1]. People who are tall
and/or overweight will breathe more than someone who is short and/or thin (based on Body

Surface Area, BSA). Each inhalation brings in about 500 ml of air, corresponding to 6 to 10 litres
of air per minute, together with any contaminants that the air contains. Please note that people
who smoke, and/or have pulmonary sickness will breathe almost 2-3 times more air than an
average person[2].
In an average person, the respiratory rate in cubic feet per minute is (worst-case):

For a helium tank containing 14.9 cubic feet of helium, the tank should last:

For someone with asthma, or heart disease:

Making the 14.8 cu ft helium tank last:

Which purity of helium is needed?[edit]

Q: How important is the purity of the helium, and what's acceptable?
A: In general terms, balloon-grade helium is sufficient to cause death if it is the only gas an
individual is breathing. Any gas that contains no oxygen will kill you if it's all you're breathing,
but some gasses trigger unpleasant responses.
Q: What is the concern about CO2 in this method?
A: While it's true that any gas mixture without oxygen will black you out pretty quick, I need to
add a minor correction about CO2: At concentrations > 30%, CO2 will drop you with little or no
warning, even with 'normal' levels of oxygen. At higher concentrations, CO2 acts like an
anesthetic and then kills rapidly. The 'unpleasant' effects all come from lower concentrations of
CO2. CO2 kills unwary people all the time, including people who deliver it for soft drink
fountains, people who hang out in low places near volcanic activity, people who work with
agricultural waste, people who work in grain silos, people in coal mines, and people unfortunate

enough to be near places like Lake Nyos when it gassed over. In most such cases, they were 'fine'
one moment and unconscious the next.
http://www.emedmag.com/html/pre/tox/0500.asp
http://www.snopes.com/horrors/freakish/smother.asp

But if the helium runs out wouldn't I suffocate?[edit]

A: In a sealed-in area, yes you would, eventually. But you'd be more likely to suffocate from
CO2 instead of helium, and CO2 suffocation - at least at a slower rates of air infusion - can be
very unpleasant. The body's evolved some rather nasty responses to CO2 poisoning because it's a
kind of poisoning virtually all oxygen-breathing mammals are prone to - choking, suffocation,
etc.... The body has learned when CO2 levels increase, it needs to do whatever it can to make
you breathe harder or clear your breathing passages, and so you convulse and cramp in all sorts
of nasty, painful ways, Unless of course you can get just about immediately into a very highconcentration of CO2 quickly, where it can drop you pretty fast. But bags over the head relying
on CO2 to do the job don't tend to work that well. The body has learned no such response to
helium, and while in the early stages of helium, the body can still release CO2 for a time. More
so than to acquire oxygen, the primary functions of breathing is to release CO2 from the body.
It's the pressure to release CO2 that causes that "I thought my chest was going to explode"
feeling in near-drowning victims. Acquiring oxygen is a secondary function of breathing - just as
vital, but as strange as it may sound, you can survive longer without oxygen coming into your
body than you can without being able to release CO2 (which you can't do if CO2 is what you're
breathing - at best, you're shuffling individual CO2 molecules around, and the body doesn't know
the difference between one that's already been through and one that's just arriving). Both
functions are vital, of course, and we'd die in fairly short-order without the ability to do either
one. But CO2 poisoning is the more critical issue to the body, which is why the body reacts to
CO2 gas but not to certain other kinds of gas. Other inert, non-irritating gasses allow the
continued release of CO2 for a time, which keeps the body off- guard for awhile. With those
types of gasses, it's too late for the body to react by the time it realizes it's not receiving any more
oxygen.

Q: How is removing CO2 going to kill you?[edit]

A: If you mean tanks that aren't filled O2, but rather nitrous oxide or helium, then there's no need
for scrubbing out CO2. Helium doesn't become CHe when inhaled, it stays helium. Same with
nitrous oxide. Your body doesn't convert the gas at all. The same breath of helium can be used
over and over until you're dead.

Q: What final exit says and what's missing there?[edit]

A: The book (I sprung for it finally after failing) suggests running a tube from the helium tank to
a plastic bag which is positioned on top of your head with a rubber band or such around your
forehead to hold the bag in place. Let the bag fill with helium, EXHALE, and then pull the bag
down over your face positioning the rubber band around your neck to hold it in place.

Q: Some issues which may arise when buying the balloon kit tank?[edit]
Template:Horizontal rule
A: The gas tanks that are supplied for filling balloons have an unusual outlet. It consists of a
spring-loaded nozzle, which when bent, opens a valve to allow the gas out. Filling the balloon in
a matter of seconds. When the nozzle is released, the spring forces the nozzle back to the
horizontal position and the metal plunger slides back against a stop, cutting off the gas flow.
There is a master valve on the top of the cylinder too, but it doesn't allow for much flow
regulation. In that case we recommend on getting a proper gas regulator valve, to replace the one
on the cylinder. This is one of the reasons I prefer obtaining a proper helium gas directly from the
helium supplier (all gas agencies would sell it to you).if they ask you why do you need it, you
can obviously say you are starting maybe a party line, and you'd like to first buy a small tank
[14.9 cu ft or so]to test is in a private party, "to see how it goes". Most suppliers will offer the
regulator immediately, thus preventing the extra hassle of taking care of it.

Q: what is most important to take care of before pulling the bag over the head?
[edit]
A: It is important to make sure there's no air in the bag or in your lungs before starting. Having
air in the bag would interfere with losing consciousness, while having air in your lungs would
cause panic attack due to CO2 build up.