During reassessment of a blunt abdominal trauma patient with decreased consciousness and shallow respirations, which action is appropriate?

• A. perform a comprehensive secondary assessment to determine why his clinical status has changed.
• B. reassess his vital signs and then notify the receiving hospital of the change in his clinical status.
• C. insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM.
• D. suction his oropharynx to ensure it is clear of secretions and then increase the oxygen flow rate to 15 L/min.

Answer: (C)

The priority is to secure the airway and support ventilation when a trauma patient has decreased consciousness and shallow respirations. An airway adjunct helps keep the airway open by preventing the tongue and relaxed tissues from blocking airflow, and starting bag-valve-mask ventilation provides the necessary breaths and oxygen until breathing improves or more advanced support is available. Delaying airway and ventilation to perform a full secondary assessment risks hypoxia, which can worsen outcomes in trauma. While suctioning and notifying the receiving facility are important, they come after ensuring the patient is adequately ventilated.