What is the next action when a patient shows cyanosis and sternal retraction after a jaw thrust and PPV intervention?

When a patient exhibits cyanosis and sternal retraction following jaw thrust and positive pressure ventilation (PPV), it likely indicates inadequate ventilation or oxygenation, and immediate action is crucial. Administering succinylcholine is pertinent in this context, especially if there's a need for rapid intubation or if the airway cannot be effectively managed by PPV alone. Succinylcholine is a neuromuscular blocker that facilitates rapid sequence intubation, allowing for improved airway control and ventilation when a patient is unable to do so independently.

In situations where PPV has not resolved the breathing difficulties and there are signs of severe respiratory distress or ineffective ventilation, it is critical to establish a secure airway promptly, which succinylcholine can help achieve. This step is particularly vital if the patient is not responding to more conservative measures like PPV, high-flow oxygen, or checking the breathing circuit.

Continuing PPV may be appropriate in some instances, but if there are observable signs of failure to ventilate such as cyanosis and retractions, it could be insufficient. Applying high-flow oxygen may improve oxygenation but does not address the underlying issue of ventilation failure. Reassessing the breathing circuit might help identify potential obstructions or disconnections