What additional measure should be taken for a pediatric patient with a heart rate under 60 BPM?

In situations where a pediatric patient presents with a heart rate under 60 beats per minute, it's crucial to assess the overall perfusion status, as bradycardia can be a result of compromised circulatory status. If the patient exhibits signs of poor perfusion—such as altered mental status, weak peripheral pulses, or cool, clammy skin—immediate action is necessary.

Beginning CPR is essential in this context because a heart rate under 60 BPM in a child, especially when combined with poor perfusion signs, indicates that the child's heart might not be effectively circulating blood to vital organs. This presents a risk of cardiac arrest if not addressed promptly. Immediate CPR can help restore circulation and oxygenation until advanced medical help is available.

Monitoring blood glucose levels, administering IV fluids, or consulting with a pediatric specialist can be important in the overall management of a pediatric patient, but they do not address the immediate risk posed by low heart rate and poor perfusion as effectively as initiating CPR would. The swift decision to start CPR ensures that the child has the best chance of recovery in an emergent situation.