A child came to casualty after seizures. On examination, respiratory rate is 5 per min. pulse 54 per min and cyanosis is present. What should be the next step of management?
**Core Concept**
This question tests the immediate management of a child with **respiratory compromise** and **cyanosis**, likely due to a life-threatening condition like **respiratory failure** or **cardiac arrest**. The priority in such cases is the ABCs (Airway, Breathing, Circulation) as per advanced pediatric life support (APLS) guidelines.
**Why the Correct Answer is Right**
The child’s **respiratory rate of 5/min** and **pulse of 54/min** indicate **severe bradycardia** and **respiratory failure**, likely secondary to central nervous system depression (e.g., from seizures or metabolic encephalopathy). **Cyanosis** suggests hypoxia. The next step is to **secure the airway and provide assisted ventilation** with 100% oxygen. Intubation may be required if spontaneous breathing does not improve, as inadequate oxygenation can worsen brain injury from postictal states or underlying causes like hypoglycemia.
**Why Each Wrong Option is Incorrect**
**Option A:** Administering anticonvulsants is secondary to stabilizing airway/breathing.
**Option B:** Checking blood glucose is a critical diagnostic step but not the immediate action.
**Option D:** Initiating chest compressions is only indicated if there is cardiac arrest (no pulse), but the question does not confirm this.
**Clinical Pearl / High-Yield Fact**
In pediatric emergencies, **always prioritize ABCs first**. Cyanosis and bradycardia are late signs of respiratory failure; early recognition of airway compromise is critical. Remember: **“Airway first”** in any acute crisis.
**Correct Answer: C. Secure airway and provide assisted ventilation**