If a child has a pulse of ≤ 60 bpm and shows poor perfusion, what is the appropriate action?

When a child has a pulse of 60 beats per minute or less and exhibits signs of poor perfusion, initiating CPR is the critical action to take. This situation indicates that the child's heart is not effectively pumping blood to the body, which can lead to inadequate oxygen delivery to vital organs.

Beginning CPR immediately is essential because it helps to restore circulation and oxygenation. The guidelines for pediatric advanced life support clearly emphasize that if a child's heart rate falls below 60 beats per minute, especially with poor perfusion, this is a sign of impending cardiac arrest, necessitating the start of chest compressions. Alongside the initiation of CPR, it's also important to call for help to ensure that advanced medical support is on the way.

Other options, such as just monitoring the child or providing only rescue breaths without compressions, do not address the need for immediate intervention in this critical condition. Effective CPR can help to stabilize the child until further medical assistance arrives.