If respirations exceed 28 breaths/min or are fewer than 8 breaths/min or are too shallow to provide adequate air exchange, consider providing _________.

• A. Positive-Pressure Ventilations With An Airway Adjunct
• B. Mouth-To-Mouth Ventilation
• C. Supplemental Oxygen By Nasal Cannula
• D. Bag-Valve-Mask Ventilation Without An Adjunct

Answer: (A)

When breathing is inadequate—either too fast, too slow, or too shallow—the patient needs assisted ventilation rather than just supplemental oxygen. The best way to provide that support is by delivering positive-pressure breaths with a bag-valve-mask device, and using an airway adjunct to keep the airway open and to help seal the mask effectively. The airway adjunct (such as an oropharyngeal or nasopharyngeal airway) prevents the tongue or soft tissues from blocking the airway and helps ensure the breaths reach the lungs.

Mouth-to-mouth ventilation is less reliable and poses greater exposure risk for the rescuer. Supplemental oxygen by nasal cannula only oxygenates and does not provide ventilation, which is insufficient when the patient isn’t breathing adequately. Bag-valve-mask ventilation without an adjunct can still ventilate but is harder to seal and more prone to airway obstruction, making the breaths less effective. Therefore, providing positive-pressure ventilations with an airway adjunct offers the most reliable and controlled way to restore adequate air exchange.