The correct answer is A. Remove the airway and ventilate him.
In pediatric patients, improper placement or incorrect sizing of an oropharyngeal airway (OPA) can cause:
Airway obstruction instead of opening
Worsening hypoxia
Leading to cyanosis and bradycardia
The patient’s cyanosis (low oxygen) and bradycardia (late hypoxia sign) indicate that the airway intervention has failed or worsened the situation.
Immediate action is to:
Remove the OPA
Provide effective ventilations with BVM
B. Continue ventilation with the airway in place → Incorrect because the airway is likely malpositioned or obstructing airflow
C. Increase ventilation rate to 40–60 → Excessive and inappropriate; does not correct obstruction
D. Start CPR if HR < 100 → In pediatrics, CPR begins if HR < 60 with poor perfusion, not < 100
“If an airway adjunct worsens ventilation, it should be removed immediately.”
“Bradycardia in infants is a sign of hypoxia.”
“Ensure adequate ventilation before initiating compressions.”
[References:, NREMT EMT Education Standards – Airway, Respiration & Ventilation, National EMS Education Standards – Pediatric Airway Management, NREMT Candidate Handbook – Airway Management and Resuscitation, ====================================, ]
