An unresponsive infant has a pulse of 76 and shallow breathing. What should be your first action?

In the scenario where an unresponsive infant has a low pulse of 76 beats per minute and shallow breathing, the first action should be to assist with ventilation. This is because the infant is showing signs of inadequate breathing, as indicated by the shallow respiratory effort.

Infants require a heart rate of at least 100 beats per minute for effective circulation. A pulse of 76 indicates bradycardia, which is a concerning sign as it suggests that the infant may not be adequately perfusing their organs. The immediate priority in situations of respiratory compromise is to ensure that the infant is receiving sufficient oxygen. Assisting with ventilation can help restore adequate oxygenation and support the infant's respiratory needs until further assessments and interventions can be performed.

The focus on ventilation is critical, as prolonged periods of hypoxia can lead to more severe complications, including cardiac arrest. Once you stabilize the airway and ensure the infant is being ventilated properly, further actions, such as checking the heart rate, performing chest compressions if required, and assessing blood pressure can be taken as part of the overall management.