Final answer:
You should check for an airway obstruction when encountering resistance while ventilating an unresponsive child. If the obstruction cannot be cleared and there is no pulse, begin CPR with chest compressions at a rate of 100 per minute and a depth of at least 5 cm. For choking, employ back slaps or the Heimlich maneuver, and call for emergency care if needed.
Step-by-step explanation:
When you are ventilating an unresponsive 4-year-old male with a bag-valve-mask device and you detect increasing resistance to ventilation, you should check for airway obstruction. This means looking for anything that might be blocking the child's airway and removing it if possible. If ventilation is still impeded after addressing the obstruction, adjustments to ventilation technique could be needed, or advanced airway placement by trained professionals may be required. It is essential to maintain an open airway to ensure effective oxygen delivery to the patient's lungs and organs.
If the obstruction cannot be cleared and the patient becomes pulseless, CPR (cardiopulmonary resuscitation) should be initiated. This technique involves applying pressure to the sternum, which compresses the heart between the sternum and the vertebrae, pushing blood through the pulmonary and systemic circuits. For quality chest compressions, a rate of 100 compressions per minute at a depth of at least 5 cm is the current guideline, reflecting the importance of manual circulation in critical situations before advanced medical care can intervene.
Additionally, for choking individuals, especially infants or older people, measures such as back slaps or the Heimlich maneuver may be necessary to relieve the obstruction before performing CPR if the patient is unresponsive and not breathing properly due to choking. However, always call for emergency medical care if you cannot promptly relieve the obstruction or if the patient's condition warrants immediate professional intervention.