While removing secretions via flexible bronchoscopy, the ECG monitor shows tachycardia and multiple PVC. The neonata/pediatric specialist should recommend the immediate administration of

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

Answer: (A)

When airway instrumentation during bronchoscopy leads to tachycardia and PVCs in a neonate or child, the most likely issue is inadequate oxygenation. The immediate step is to give supplemental oxygen to improve arterial oxygen content and reduce myocardial irritability. Quick oxygen delivery often corrects the arrhythmia by correcting hypoxemia and stabilizing the heart.

Lidocaine could be considered for certain ventricular arrhythmias, but it doesn’t address the underlying cause here and isn’t the first move during a procedure with potential hypoxemia. Topical anesthetics carry risks of systemic toxicity and aren’t used to treat this scenario. A beta-adrenergic agent would raise heart rate and could worsen arrhythmias, making it inappropriate in this setting.