What action should be taken if a child's pulse decreases to 50 bpm with signs of poor perfusion?

When a child's pulse decreases to 50 beats per minute accompanied by signs of poor perfusion—such as pale or mottled skin, cool extremities, or altered consciousness—this indicates a potentially life-threatening situation. A pulse rate this low suggests bradycardia, which can compromise oxygen delivery to vital organs. When combined with signs of poor perfusion, it requires immediate intervention.

Starting CPR is the appropriate action because it helps restore circulation and improve oxygen delivery to the body's tissues. It is essential to follow the recognized protocols for pediatric resuscitation, which include calling for help, ensuring the environment is safe, and beginning chest compressions promptly. Administering oxygen or other measures, such as monitoring the child or performing abdominal thrusts, do not address the immediate life-threatening condition presented by the low pulse and poor perfusion. Therefore, initiating CPR is critical in this scenario to improve the child's chances of survival.