The accuracy and stability of manual ventilation can contribute to the quality of ventilation and the prevention of acute and chronic pulmonary complications in neonates. In this study pediatric house staff and nurses in the intensive care nursery manually ventilated a teaching mannequin at predetermined "low" and "high" peak inspiratory pressures. Without using a pressure manometer, 18% and 13% achieved desired peak inspiratory pressures of 15 and 30 cm H2O, respectively, vs 72% and 74% when a manometer was used for a mean of 90 ventilations. Median and maximal group deviations from the assigned pressures were significantly lower when a pressure gauge was used. Our results demonstrated that accuracy of manual ventilation can be better achieved when a manometer is used in conjunction with infant resuscitation bags.