A 7-month-old infant developed cardiac arrest. You and your colleagues are performing CPR. What should be the compression to ventilation ratio maintained?

1. A

   30:2

2. B

   15:1

3. C

   30:1

4. D

   15:2

Appeared in: RML 2023

Explanation

• The key to this question is identifying the number of rescuers; the phrase 'you and your colleagues' indicates two or more rescuers are present.
• According to American Heart Association (AHA) guidelines, the correct compression-to-ventilation ratio for two-rescuer CPR on an infant is 15 compressions to 2 breaths (15:2).
• This ratio is different from single-rescuer CPR because pediatric cardiac arrests are often due to respiratory failure, and the 15:2 ratio provides more frequent ventilations.

Why Other Options Were Wrong

• Option A: The 30:2 ratio is used for single-rescuer CPR in all age groups (infants, children, adults).
• Option B: A ratio of 15:1 is not a standard, recommended compression-to-ventilation ratio in any official CPR guidelines.
• Option C: A ratio of 30:1 is not a standard CPR ratio. While neonatal resuscitation for newborns uses a 3:1 ratio, this patient is a 7-month-old infant, not a neonate.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric CPR: Compression-to-Ventilation Ratio as background academic context rather than a clinical decision trigger.
• In a pediatric code situation, effective teamwork and clear communication are essential. The team leader should ensure everyone is aware of their role and that the correct CPR ratio is being used.
• Using the 15:2 ratio in a two-rescuer scenario maximizes the chances of a good outcome by addressing the high likelihood of a respiratory cause for the arrest.
• What if? If one of your colleagues had to leave the room, leaving you as the sole rescuer, you would immediately switch from a 15:2 ratio to a 30:2 ratio to continue providing effective CPR.

How to Approach the Question

• First, identify the patient's age: '7-month-old infant'. This tells you to apply pediatric guidelines.
• Second, identify the clinical situation: 'cardiac arrest' and 'performing CPR'.
• Third, and most critically, determine the number of rescuers. The phrase 'you and your colleagues' clearly indicates two or more rescuers.
• Recall the specific AHA guideline for two-rescuer infant CPR, which is a 15:2 compression-to-ventilation ratio.
• Eliminate other options by recalling that 30:2 is for single-rescuer CPR, and 15:1/30:1 are not standard ratios.

Concept Tested & Keywords

• Concept Tested: Pediatric CPR: Compression-to-Ventilation Ratio
• Stem keywords: 7-month-old infant, cardiac arrest, CPR, you and your colleagues
• Lead-in keywords: What should be
• Clinical cues: The phrase 'you and your colleagues' is a critical cue indicating that there are two or more rescuers, which dictates the specific CPR protocol to be used.
• Negative lead-in flag: false

Question ID

QBDaXp3qHyd4LBgmIHnVP4

Copy ID

Reference Book

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 763-765

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 610-612