In any suspicion of neurological injury, which action is recommended if SpO2 < 90% or hypoventilation occurs despite high-flow oxygen?

• A. Assist ventilations with a BVM
• B. Apply cooling measures to the head
• C. Administer intravenous fluids only
• D. Delay ventilation until hospital

Answer: (A)

When there is suspected neurological injury, keeping the airway and ensuring adequate ventilation is crucial because the brain cannot tolerate low oxygen. If the pulse oximetry is below 90% or the patient is not ventilating adequately even with high-flow oxygen, you must assist ventilations to restore proper oxygen delivery and carbon dioxide removal. Using a bag-valve mask provides controlled breaths, increases delivered tidal volume, and helps improve both oxygenation and ventilation. This helps prevent further brain injury from hypoxemia. Cooling measures don’t fix low oxygen levels, intravenous fluids alone don’t address ventilation, and delaying ventilation only allows brain injury to worsen. So, the correct immediate action is to assist ventilations with a bag-valve mask.