Question

a 72-year-old complains of chest pain and difficulty breathing. the patient suddenly vomits and the heart stops beating. what is your first priority?

begin rescue ventilations with a bvm.
compressions and clearing the airway.
roll the patient onto the stomach.
insert an adjunct airway.

Explanation:

Analyze the clinical scenario

The patient is a 72-year-old in cardiac arrest ("heart stops beating") immediately after vomiting. In any cardiac arrest, high-quality chest compressions are vital, but a compromised airway due to active vomiting must be cleared immediately to prevent aspiration and allow effective ventilation.

Evaluate the airway priority

Using the Airway Management Protocols knowledge point

• Active vomit in the airway blocks airflow and causes severe aspiration.
• Clearing the airway (via suctioning or manual clearing) must occur alongside starting chest compressions.
• Ventilating with a BVM before clearing the airway would force vomit into the lungs.

Assess the remaining options

Using the BVM Ventilation Protocols knowledge point

• Begin rescue ventilations with a BVM: Contraindicated while the airway is full of vomit, as it causes aspiration.
• Roll the patient onto the stomach: Incorrect; the patient needs to be supine for CPR, though a recovery position or log-roll is used temporarily to drain vomit.
• Insert an adjunct airway: An adjunct (like an OPA) cannot be safely placed or utilized until the airway is cleared of liquid vomit.

Answer:

• Begin rescue ventilations with a BVM.
• Compressions and clearing the airway. (Correct answer)
• Roll the patient onto the stomach.
• Insert an adjunct airway.