How should you respond to a child in respiratory arrest or failure if their central pulse is greater than 60 bpm?

When a child is experiencing respiratory arrest or failure but has a central pulse greater than 60 beats per minute, the appropriate response is to deliver one ventilation every 2 to 3 seconds. This approach is vital because, in situations of respiratory distress where circulation is still functioning (indicated by the pulse), the focus should be on providing adequate breaths to ensure that oxygen can be delivered to the body and brain.

The rationale behind this is that, while the heart is still pumping blood, the main issue is the ineffective breathing or absence of self-respiration. By administering ventilations at this rate, you provide a controlled way to increase oxygenation and ventilation until advanced medical help is available or the child's respiratory status improves.

In contrast, starting CPR immediately is not necessary in this circumstance because the central pulse indicates that there is still circulation; CPR is reserved for situations where there is no pulse. Simply providing oxygen without actively ventilating may not sufficiently assist the child if they are not breathing effectively on their own. Continuous ventilations without a pause for evaluation of effectiveness may lead to hyperventilation, which can be detrimental. The selected answer effectively addresses the immediate need for ventilation while being mindful of the circulatory status of the child.