When should a pediatric patient be intubated during CPR?

• A. Immediately at the start of CPR
• B. If airway compromise persists or ventilation remains inadequate after basic maneuvers; RSI if trained
• C. Only if there is a witnessed cardiac arrest
• D. Never during CPR

Answer: (B)

In pediatric CPR, you start with simple airway maneuvers and bag‑valve‑mask ventilation to maintain oxygen delivery. Endotracheal intubation is considered only if current airway management is not keeping ventilation adequate or if there is ongoing airway compromise that basic measures can’t correct. If you are trained and comfortable performing it, rapid sequence intubation can be used to secure the airway quickly and with fewer interruptions to chest compressions. The goal is to minimize pauses in compressions while ensuring effective ventilation and protecting the airway. Starting intubation immediately at the outset isn’t necessary and can delay high‑quality CPR, and you would not wait indefinitely for a witnessed arrest or never pursue advanced airway in a child who isn’t ventilating well.