What should be done if a child in respiratory arrest has a central pulse decrease to 50 bpm with signs of poor perfusion?

When a child in respiratory arrest exhibits a central pulse that decreases to 50 beats per minute along with signs of poor perfusion, immediate action is necessary. A heart rate below 60 beats per minute in an infant or child, especially when accompanied by poor perfusion, indicates a critical situation requiring urgent intervention.

In this instance, starting CPR is essential because the child's heartbeat is compromised, and they are not breathing adequately. Without intervention, the child cannot sustain life, and initiating CPR helps to circulate oxygenated blood to vital organs, which is crucial in cases of cardiac or respiratory distress.

Monitoring alone would not address the falling heart rate or the signs of poor perfusion, and reassessing breathing without taking action could lead to further complications. Administering oral fluids is inappropriate in this life-threatening scenario, as the child cannot effectively swallow or manage fluids when in respiratory arrest. Therefore, the immediate and appropriate response is to start CPR to restore adequate circulation and breathing.