In a mass casualty triage scenario, a child who is not breathing spontaneously after airway repositioning should have which action next?

• A. Start chest compressions immediately
• B. Check for a pulse and wait
• C. Give five rescue breaths
• D. Elevate the head and wait for spontaneous breathing

Answer: (C)

In pediatric mass casualty triage, when a child remains not breathing after airway repositioning, the immediate action is to give five rescue breaths. This reflects the reality that respiratory failure is a common cause of pediatric arrests, and restoring ventilation can quickly reoxygenate and sometimes restore breathing. After delivering those five breaths, you reassess: if breathing returns and a pulse is present, continue monitoring or ventilation as needed; if there is no pulse, you begin chest compressions; if a pulse exists but the child still isn’t breathing, you continue rescue breaths. The other options delay ventilation or jump to chest compressions prematurely, which is not the optimal next step in this scenario.