A 74-year-old patient is unresponsive and you hear gurgling sounds on inspiration. What is the first action you should take?

• A. Ventilate with a bag-valve mask
• B. Insert a nasopharyngeal airway
• C. Suction the airway
• D. Log roll the patient to the recovery position

Answer: (C)

When you hear gurgling in an unresponsive patient, secretions or vomitus are pooling in the airway, blocking air passage. The first action is to suction the airway to remove those secretions so air can flow and ventilation can be effective. After clearing the airway, reassess breathing and provide ventilation with a bag-valve mask if needed. A nasopharyngeal airway may help keep the airway open after suctioning, but it won’t remove the obstruction and isn’t the first step here. Log-rolling to the recovery position doesn’t address the current obstruction and isn’t the immediate priority.