A 5-year-old child is rushed to casualty reportedly electrocuted while playing in a park. The child is apneic and is ventilated with bag and mask. There are burns on each hand. What will be the next step in the management-
Ans. is 'a' i.e., Check pulses An orderly sequence of events in resuscitation is (A, B, C) airway, breathing and circulation.If the patient has no spontaneous respirations, steps should be immediately taken to breathe for the child Airway should be opened and rescue breathing should be provided.Rescue breathing is done by Mouth to mouth Mouth to nose Mouth to mask Bag mask respirationsSuccessful rescue breathing will provide good chest rise and relief of deep cyanosis.Usually after bag and mask ventilation it should be checked whether spontaneous ventilation is present or not. This is assessed by watching the chest movements If these do not indicate adequate ventilation, immediate intubation is the next step.But in the question they have not specified, whether the ventilation is adequate or not (after the oxygenation). If they wanted to know this, it would have been specifically mentioned in the question that the patient remained in apnea after the bag & mask ventilation.So we can assume that the ventilation becomes normal after bag and mask ventilation.Once the respiratory system is taken care of cardiovascular system needs attention.Circulation should be first assessed by checking the pulse.If there is no pulse or if the pulse is less than 60 beats/m with poor perfusion chest compression must be given.
Check pulses
Start chest compressions
Intubate
Check oxygen'saturation