An unresponsive 2-year-old has been sick for four days. What is your next step?

In a scenario with an unresponsive 2-year-old child who has been sick for four days, the appropriate next step is to assess their breathing and pulse. This step is crucial in determining the current state of the child's cardiovascular and respiratory function. By checking for breathing and pulse, you can identify whether the child is experiencing respiratory distress, an airway obstruction, or cardiac arrest.

Assessment of breathing involves observing for chest rise, listening for breathing sounds, and feeling for air movement at the child's mouth or nose. Checking for a pulse is done by feeling for the femoral or carotid pulse in infants and small children. This assessment will guide the responder in choosing the correct intervention, whether that means providing rescue breaths, starting chest compressions, or initiating CPR based on the child's responsiveness and vital signs.

If the child is not breathing and lacks a pulse, then immediate CPR would be appropriate. Conversely, if there is a pulse but the child is unresponsive, rescue breaths might need to be provided. Thus, the initial emphasis on assessing breathing and pulse is vital for delivering proper care tailored to the child's needs.