If a patient with blunt abdominal trauma develops shallow respirations, what is the recommended airway management step first?

• A. increase the oxygen flow rate
• B. suction the oropharynx to clear secretions
• C. insert an airway adjunct and begin assisting ventilations with a BVM
• D. perform a comprehensive secondary assessment

Answer: (C)

When someone has shallow respirations after blunt trauma, the immediate priority is to secure and support the airway to ensure adequate ventilation and oxygenation. Using an airway adjunct helps keep the airway open and prevents obstruction from the tongue or soft tissues, especially if consciousness is decreased. Starting bag-valve-mask ventilation right away provides positive pressure to move air in and out, delivering oxygen and removing carbon dioxide as you stabilize the airway.

This approach directly addresses the breathing problem you’re seeing, which is more urgent than simply increasing the oxygen flow rate or performing other tasks. Suctioning the oropharynx might be needed if there’s an obstruction, but it doesn’t fix shallow breathing by itself. A comprehensive secondary assessment is important, but it comes after you’ve ensured the airway and breathing are supported. Protecting the cervical spine during airway management is also important in trauma, so maintain stabilization while you insert the airway adjunct and begin ventilations.