Emergency Medical Technician (EMT) Intermediate Practice Exam

An apneic 2-year-old child with a heart rate of 110 beats/min is being ventilated with a bag-mask device at a rate of 20 breaths/min. After 2 minutes of ventilations, you note that the child's heart rate is 80 beats/min. You should:

1. Increase the ventilation rate

2. Recognize that your ventilations are not adequate

3. Administer supplemental oxygen

4. Reassess the child's breathing pattern

The correct answer is: Recognize that your ventilations are not adequate

In this scenario, recognizing that the ventilations are not adequate is crucial. The child's heart rate has dropped from 110 beats per minute to 80 beats per minute after two minutes of ventilation, indicating that the child is not receiving sufficient oxygenation or ventilation. A decrease in heart rate, especially in a child, is a concerning sign that points to potential hypoxia or inadequate ventilation. The recommended rate for ventilating a child can be around 20 breaths per minute; however, if the child is not responding positively—evidenced by the dropping heart rate—this is an indicator that adjustments are necessary. The priority here is to ensure that ventilations are effective and that the child is adequately oxygenated, as a continuing drop in heart rate could lead to further complications. By recognizing that the ventilations are not adequate, further steps can be taken to reassess the effectiveness of the bag-mask device and potentially make adjustments such as ensuring a proper seal, modifying the ventilation technique, or increasing the ventilation rate if necessary. Each of these modifications aims to restore and maintain adequate oxygenation and ultimately improve the child's heart rate.