A law enforcement restrained a 26-year-old male who collapsed unresponsive, apneic, and pulseless. What is the first action you should take?

• A. Begin chest compressions
• B. Open his airway
• C. Attach AED
• D. Ventilate him

Answer: (D)

The key idea here is to restore oxygen delivery to the brain and vital organs as quickly as possible when a patient is unresponsive and not breathing. Because the person is apneic, providing rescue breaths establishes the necessary oxygen exchange in the lungs. Without ventilation, circulating blood—even if chest compressions are started—will carry deoxygenated blood to tissues, which can worsen outcomes. So the first action is to open the airway and deliver breaths immediately, using a barrier device if available, and ensure a visible chest rise with each breath. After initiating ventilation, you would assess for a pulse and, if no pulse is found, begin chest compressions to circulate the oxygenated blood you’ve just provided, while continuing to defibrillate with the AED as soon as it’s ready.