What is the next step after finding a confused male at a pool with a head hematoma and adequate breathing?

After finding a confused individual with a head hematoma and adequate breathing, the most appropriate next step is to take in-line spinal stabilization and apply a cervical collar. This choice is crucial because head injuries can sometimes be associated with spinal injuries, and the combination of confusion and a head hematoma raises the suspicion of potential trauma to both the head and cervical spine.

Applying in-line stabilization helps to prevent any movement that could exacerbate a spinal injury, while the cervical collar serves to immobilize the neck and restrict motion. This is important to minimize the risk of further injury, particularly when there is altered mental status, which could indicate more serious underlying issues.

Addressing the patient's spinal stability is a priority, especially in a wilderness setting where advanced medical care may not be immediately accessible. By stabilizing the head and neck, you are ensuring that any transport or further assessment can be done safely without risking additional harm.

While administering oxygen could promote better oxygenation, and reassessing the level of consciousness is certainly important, these steps should follow the immediate stabilization of the cervical spine. Requesting advanced life support might be necessary later, but it is essential to first ensure the patient's current safety and minimize risks during assessment and potential transport.