In breech delivery, which technique is described to create an airway for the newborn?

• A. Endotracheal tube insertion
• B. Two gloved fingers placed at each side of the nose to create an airway (correct)
• C. Mouth-to-mouth ventilation
• D. Neonatal mask with bag-valve

Answer: (B)

In breech delivery, the newborn’s airway can become obstructed while the body is delivered and the head is still to come. The quickest way to ensure that air can reach the lungs is to manually open a path for air by placing gloved fingers at each side of the nose to gently keep the nostrils open, creating a simple, temporary nasal airway. This provides a route for ventilation when the mouth may be blocked or not yet accessible, buying time for safer, more definitive airway management to be established after delivery of the head. It’s fast, requires minimal equipment, and helps prevent hypoxia during this critical moment. The other options—mouth-to-mouth ventilation, bag-valve-face ventilation with a neonatal mask, or attempting an endotracheal tube—are more technically demanding or not immediately feasible in the breech scenario, so this finger-nostril method is the most practical immediate airway aid.