What should you do if a child in respiratory arrest has a central pulse of less than or equal to 60 bpm and shows signs of poor perfusion?

In the scenario where a child is in respiratory arrest and has a central pulse of less than or equal to 60 beats per minute, along with signs of poor perfusion, the appropriate response is to start CPR immediately. This is because a pulse rate that low indicates that the heart is not effectively pumping blood, which compromises oxygen delivery to vital organs.

CPR is critical in this situation as it helps to maintain circulation and oxygenation until advanced medical help is available. The immediate initiation of CPR is vital for preserving neurological function and increasing the chances of survival. Providing compressions assists in artificially circulating blood through the heart and lungs, which is essential given the child's condition.

Other options, such as administering oxygen and monitoring or providing ventilation every few seconds, do not address the urgent need to restore circulation due to the very slow heart rate and poor perfusion. Waiting for the child to wake up is not appropriate, as it does not respond to the immediate critical life-threatening situation. Therefore, starting CPR is the best course of action in this life-threatening scenario.