You are caring for a child in respiratory arrest with a pulse of 55 bpm. What is the best immediate action?

In the scenario presented, the child is in respiratory arrest with a pulse of 55 beats per minute, which is considered bradycardia (abnormally slow heart rate for a child). When a child is in respiratory arrest, the priority is to ensure that oxygen is being delivered to the body, particularly to the brain and vital organs.

The best immediate action in this case is to start CPR, as it addresses the critical need for circulation and oxygenation. Initiating CPR provides chest compressions which can help to maintain some degree of blood flow to vital organs despite the child’s ineffective breathing. Even though the child has a pulse, the bradycardic rate indicates that the heart is not pumping effectively, and CPR can be beneficial when breathing has stopped.

Other options, while relevant in different contexts, do not provide the immediate response required under these circumstances. Ventilation alone cannot restore adequate perfusion when the heart rate is critically low. Moreover, performing a secondary assessment or placing the child in the recovery position does not address the urgency of the situation, where immediate action is necessary to prevent further deterioration. Therefore, starting CPR is the most effective response to ensure the child receives critical care at this moment.