If ventilation is unacceptable during cardiac arrest, what should be done?

• A. Perform a cricothyrotomy if unable to ventilate by any other means.
• B. Continue ventilation with bag-mask only.
• C. Wait for EMS to arrive.
• D. Switch to mouth-to-mouth only.

Answer: (A)

When ventilation cannot be achieved with noninvasive methods during cardiac arrest, you must secure a airway that will allow proper ventilation. An emergency cricothyrotomy provides a direct surgical route into the trachea, bypassing obstructions and enabling effective ventilation quickly. This approach is chosen because continuing with bag-mask ventilation, waiting for EMS, or resorting to mouth-to-mouth only won’t restore adequate ventilation in a scenario where traditional methods have failed. A cricothyrotomy is intended as a rapid, decisive step when other techniques cannot establish a patent airway, assuming you’re trained and equipped to perform it.