In a pediatric patient with suspected airway obstruction during rescue breathing, what is the best ventilation approach?

• A. Deliver gentle breaths with a rate appropriate for age; avoid hyperventilation; monitor chest rise.
• B. Ventilate with rapid, forceful breaths to try to dislodge obstruction.
• C. Use adult breathing rates to ensure oxygen delivery.
• D. Pause ventilations completely to assess for obstruction.

Answer: (A)

When a child shows signs of airway obstruction while you’re providing rescue breaths, the priority is to ventilate gently with a rate appropriate for the child’s age and to watch for chest rise. Gentle breaths deliver enough air to oxygenate without creating high airway pressures that can worsen the obstruction or cause gastric inflation. Using adult breathing rates ignores the child’s smaller lungs and can lead to over-ventilation, while rapid, forceful breaths can push air past the obstruction or cause other complications. Pausing ventilation to reassess interrupts oxygen delivery. If a breath doesn’t produce chest rise, reposition the head, ensure the airway is open, and resume with gentle breaths, calling for advanced help if the obstruction persists.