An unresponsive 82-year-old female is on the concrete floor in her basement. Vital signs: BP 100/70, P 44, R 10, temperature 90°F. What should you do first?

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Multiple Choice

An unresponsive 82-year-old female is on the concrete floor in her basement. Vital signs: BP 100/70, P 44, R 10, temperature 90°F. What should you do first?

The first priority is securing the airway and supporting ventilation. An unresponsive patient with a pulse still needs adequate breathing to ensure oxygen delivery; here the respirations are only 10 per minute, which is insufficient for proper oxygenation. Providing ventilations with a bag-valve mask delivers breaths and helps raise oxygen levels quickly while you assess the rest of the situation. The presence of a pulse means you don’t start chest compressions yet. Temperature is severely low, and hypothermia can cause bradycardia, but airway and breathing support comes before other interventions like warming or IV fluids. After establishing ventilation, you can continue warming and reassess circulation and glucose as needed.

The first priority is securing the airway and supporting ventilation. An unresponsive patient with a pulse still needs adequate breathing to ensure oxygen delivery; here the respirations are only 10 per minute, which is insufficient for proper oxygenation. Providing ventilations with a bag-valve mask delivers breaths and helps raise oxygen levels quickly while you assess the rest of the situation. The presence of a pulse means you don’t start chest compressions yet. Temperature is severely low, and hypothermia can cause bradycardia, but airway and breathing support comes before other interventions like warming or IV fluids. After establishing ventilation, you can continue warming and reassess circulation and glucose as needed.

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