Which action is considered the first step in managing a paediatric patient with central cyanosis and gasping?

In the management of a pediatric patient presenting with central cyanosis and gasping, the immediate priority is to ensure adequate oxygenation and ventilation. Administering positive pressure ventilation serves this purpose by providing an effective means of delivering oxygen directly into the lungs and assisting with the patient's breathing efforts. Gasping indicates inadequate respiratory function, and without intervention, this can lead to severe hypoxia and potentially fatal outcomes.

While checking for a pulse and assessing blood pressure are important components of the overall assessment, they are not the first actions in this critical situation. The immediate need to restore adequate ventilation takes precedence over these assessments, which can be performed after ventilation is established. Furthermore, while administering oxygen support is beneficial, it does not actively support the patient’s inadequate respiratory effort as effectively as positive pressure ventilation does in this acute scenario.

Focusing on the need for immediate respiratory intervention highlights the urgency of addressing life-threatening conditions in pediatric patients, which can escalate quickly. Therefore, initiating positive pressure ventilation is the prioritized action in this context.