Board of Legal SpecializationPractice Exam

What is an appropriate action for a 4-year-old child in respiratory failure with a central pulse rate of 65 bpm?

1. Deliver 1 ventilation every 5 seconds

2. Deliver 1 ventilation every 2 to 3 seconds

3. Check pulse only every other minute

4. Perform chest compressions for 1 minute

The correct answer is: Deliver 1 ventilation every 2 to 3 seconds

In the context of a 4-year-old child experiencing respiratory failure with a central pulse rate of 65 beats per minute, delivering 1 ventilation every 2 to 3 seconds is considered the appropriate action. This guideline aligns with pediatric advanced life support (PALS) protocols, which recommend a frequency of ventilations that allows sufficient time for exhalation while maintaining adequate oxygenation. In a child, especially one who is in respiratory distress, it is crucial to provide ventilations effectively to support their oxygen needs without overwhelming the lungs. Delivering a ventilation every 2 to 3 seconds helps to ensure that the child receives enough air to improve their respiratory status while also allowing the heart rate to remain stable. Given that the pulse rate is moderately low but not indicative of cardiac arrest, this ventilation strategy is a vital part of supportive care for a child in respiratory distress. Other options might lead to inadequate care in such a situation. For instance, checking pulse only every other minute may not provide timely feedback on the child's condition, and performing chest compressions for 1 minute would be inappropriate unless there is no pulse, as chest compressions are primarily indicated for cardiac arrest, not solely for respiratory failure. Delivering a ventilation every 5 seconds is also