During bronchoscopy in a neonate, tachycardia and PVC may necessitate what immediate step?

• A. Oxygen
• B. Lidocaine
• C. Topical anesthetic
• D. Beta Adrenergic agent

Answer: (A)

When a neonate develops tachycardia and PVCs during bronchoscopy, the most immediate issue is inadequate oxygenation from airway instrumentation. Providing supplemental oxygen rapidly increases arterial oxygen content, improves tissue oxygen delivery, and helps stabilize the heart rhythm by reducing myocardial irritability from hypoxemia. In practice, you would promptly increase the inspired oxygen concentration to restore safe saturations and reassess the patient during the procedure.

The other options don’t address the core problem right away. Lidocaine or topical anesthetics carry risks of toxicity in neonates and don’t promptly correct hypoxemia or stabilize the rhythm. A beta-adrenergic agent would likely worsen tachycardia and arrhythmias rather than help.