What is your first action upon finding a drowning patient who is unresponsive with agonal respirations?

In the scenario of finding an unresponsive drowning patient with agonal respirations, the initial step involves ensuring the patient's airway is clear and protected. In this context, inserting an oropharyngeal airway (OPA) is the appropriate first action.

The rationale for this choice lies in the urgency of establishing an open airway, especially given the presence of agonal respirations, which indicate inadequate breathing effort. By placing an OPA, you can help maintain a patent airway, facilitating effective ventilation and minimizing the risk of airway obstruction, which is crucial for any unresponsive patient. Properly inserted, the OPA can prevent the tongue from falling back and blocking the airway, allowing for better access for additional life-saving interventions such as rescue breaths if needed.

Taking this action first helps to set the stage for subsequent steps in patient management. Once the airway is secured, attention can then turn to other critical tasks such as performing rescue breaths and chest compressions, especially considering the high likelihood of cardiac arrest in drowning scenarios. Requesting additional medical assistance is always an important consideration but should not delay immediate care for the unresponsive patient.