Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by:

• A. Administer sedatives
• B. Reopening the airway and reattempting to ventilate
• C. Start chest compressions
• D. Provide high-flow oxygen

Answer: (C)

In this situation the priority is to restore circulation. When an unconscious, not-breathing adult shows poor lung compliance during initial ventilation attempts, continuing to push air in without adequate blood flow won’t effectively oxygenate the brain or heart. Starting chest compressions helps generate blood flow to the lungs and to vital organs, making any future ventilation more effective and buying time to restore circulation. Sedatives would worsen the situation by depressing respiration; simply reopening the airway and retrying ventilation treats ventilation, but without perfusion the effort is limited; while providing high-flow oxygen is beneficial, it cannot substitute for the lack of circulation. So the best immediate action is to initiate chest compressions to restore perfusion.