A six-year-old with a history of asthma and retractions is unable to hold their head up. What is the appropriate intervention?

In this scenario, the six-year-old is showing signs of significant respiratory distress, as evidenced by the inability to hold their head up and the presence of retractions. These symptoms indicate that the child is not only experiencing breathing difficulty but is likely also in a state of respiratory failure or impending failure, requiring immediate intervention.

Ventilating via bag-valve mask at a high flow rate of 15 L/min is an appropriate intervention because it assists in delivering adequate ventilation and oxygenation to the child who is unable to maintain this on their own. This method can help alleviate hypercapnia (increased carbon dioxide levels) and hypoxia (lack of adequate oxygen), which are critical concerns in patients with severe respiratory distress, especially in pediatric cases like asthma exacerbations.

Other interventions, such as administering a bronchodilator, providing oxygen via nasal cannula, or assessing for wheezing, might be necessary but are secondary to the need to ensure proper ventilation in a child who is unable to maintain head control and is exhibiting significant respiratory distress. In acute situations like this, ensuring that the child is adequately ventilated takes precedence to stabilize the patient's condition.