A patient arrives unconscious with a strong odor of alcohol. What should the nurse do first?

• A. Establish a patent airway
• B. Administer glucose IV
• C. Perform a quick blood alcohol test
• D. Call the physician immediately

Answer: (A)

Securing a patent airway is the most urgent action. An unconscious patient may have a depressed gag and swallowing reflex, making airway obstruction and aspiration of vomit a real danger. By opening and protecting the airway—using positioning, suctioning as needed, and preparing airway support—you stabilize the patient enough to assess breathing and provide oxygen or ventilation if required. Other actions address other issues (like hypoglycemia) but don’t resolve the immediate life threat of an unsafe airway, so they’re not the first step.