A 4-year-old child in respiratory failure has a pulse rate of 65 bpm. What is an appropriate action?

In a situation where a 4-year-old child is in respiratory failure accompanied by a pulse rate of 65 beats per minute, the most appropriate action is to deliver 1 ventilation every 2 to 3 seconds. This approach is based on the understanding that while the child still has a pulse, their inadequate breathing is causing respiratory failure, which means they are not getting enough oxygen.

Delivering ventilations at this rate is crucial because it provides the child with the necessary air to help oxygenate their blood more effectively. The timing of every 2 to 3 seconds allows for a sufficient exchange of oxygen and carbon dioxide without overwhelming the child’s system or causing further complications.

In contrast, initiating CPR immediately would not be appropriate since the child still has a pulse, even if it is low. On the other hand, delivering 1 ventilation every 6 seconds is too infrequent and may not adequately address the child's need for oxygen in this critical situation. Checking pulse and breathing every 2 minutes could result in a delay in providing necessary ventilations and doesn't actively address the immediate need for assistance with breathing. Thus, delivering ventilations every 2 to 3 seconds is the best course of action to stabilize the child's condition.