An adult patient is breathing shallow at four times per minute. You should

• A. Provide chest compressions
• B. Provide ventilations via BVM
• C. Place in shock position
• D. Wait and observe

Answer: (B)

When ventilation is inadequate but the patient still has a pulse, the priority is to restore effective breathing rather than perform chest compressions. Delivering ventilations via a bag-valve-mask allows you to control the breaths, provide sufficient tidal volume, and, if available, deliver oxygen to improve oxygenation. After opening the airway with the head tilt–chin lift (or jaw-thrust if trauma is suspected), seal the mask and give a breath that makes the chest rise, about once every 5–6 seconds (roughly 10–12 breaths per minute). Continue this until normal breathing returns or help takes over. The other actions aren’t appropriate here: chest compressions are for no pulse, waiting and observing won’t fix inadequate ventilation, and the “shock position” isn’t a treatment for this scenario.