A 6-month-old female is cyanotic and slow to respond after an empty balloon is found in her mouth. After you begin to ventilate her, you should:

• A. Administer naloxone
• B. Begin chest compressions
• C. Assess her blood pressure
• D. Ask her father to discard the balloon

Answer: (A)

The situation is a choking emergency in an infant. The priority is to restore oxygen delivery by supporting breathing and, if needed, circulating blood. After you’ve started ventilation, you must quickly assess for signs of circulation. If there is no pulse or perfusion is poor, you should begin chest compressions to circulate oxygen to the heart, brain, and other vital organs. Naloxone reverses opioid-induced respiratory depression, not a mechanical airway obstruction like a balloon in the airway, so it would not address the underlying problem here and could delay essential chest compressions. Asking the father to discard the balloon is not appropriate during an emergency care moment; the focus should be on keeping the airway clear and maintaining circulation. In short, continue ventilations and start chest compressions if there is no pulse or poor perfusion, rather than giving naloxone.