A 45-year-old female is supine on the floor and unresponsive. Her family states prior to EMS arrival she had slurred speech. There is a laceration to her forehead with moderate bleeding. She has been depressed lately and was prescribed an antidepressant. Vital signs are BP 90/50, pulse matches ECG below, respirations 8 and shallow. What should you do?

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Multiple Choice

A 45-year-old female is supine on the floor and unresponsive. Her family states prior to EMS arrival she had slurred speech. There is a laceration to her forehead with moderate bleeding. She has been depressed lately and was prescribed an antidepressant. Vital signs are BP 90/50, pulse matches ECG below, respirations 8 and shallow. What should you do?

When someone is unresponsive and not breathing adequately, the top priority is to restore ventilation and oxygen delivery. This patient is unresponsive with respirations at 8 and shallow, so she isn’t generating enough breaths on her own. Because she still has a pulse, you don’t start chest compressions yet; you provide assisted ventilation with a bag-valve mask to deliver adequate breaths (about 10–12 per minute, one breath every 5–6 seconds) and reassess continuously. Securing and supporting her airway now helps improve oxygen delivery to brain and organs, which is the immediate danger. Naloxone would be considered if there were strong clues pointing to opioid overdose (such as pinpoint pupils, known opioid use, and a pattern of severe respiratory depression). In this scenario, the immediate need is ventilation rather than reversal with naloxone. Checking blood glucose is important, but it does not address the urgent problem of inadequate ventilation; you can assess glucose parallel to ongoing ventilation, but the priority remains supporting breathing with a bag-valve mask. Control of the forehead laceration can come after airway and breathing are stabilized.

When someone is unresponsive and not breathing adequately, the top priority is to restore ventilation and oxygen delivery. This patient is unresponsive with respirations at 8 and shallow, so she isn’t generating enough breaths on her own. Because she still has a pulse, you don’t start chest compressions yet; you provide assisted ventilation with a bag-valve mask to deliver adequate breaths (about 10–12 per minute, one breath every 5–6 seconds) and reassess continuously. Securing and supporting her airway now helps improve oxygen delivery to brain and organs, which is the immediate danger.

Naloxone would be considered if there were strong clues pointing to opioid overdose (such as pinpoint pupils, known opioid use, and a pattern of severe respiratory depression). In this scenario, the immediate need is ventilation rather than reversal with naloxone. Checking blood glucose is important, but it does not address the urgent problem of inadequate ventilation; you can assess glucose parallel to ongoing ventilation, but the priority remains supporting breathing with a bag-valve mask. Control of the forehead laceration can come after airway and breathing are stabilized.

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