What should be assessed first in a patient presenting with altered mental status?

When assessing a patient with altered mental status, the first priority is to evaluate the airway. This is crucial because if the airway is compromised or obstructed, it can lead to inadequate ventilation and subsequently result in hypoxia, which can worsen the patient's condition. A clear airway ensures that the patient can breathe adequately, allowing for the necessary oxygen exchange.

In patients with altered mental status, the risk of airway obstruction is heightened, particularly if they are unable to protect their own airway due to reduced consciousness or confusion. Therefore, promptly assessing and securing the airway can be life-saving and is the initial step in the assessment process.

Following the airway assessment, it is also vital to consider breathing and circulation, but these come after ensuring that the airway is clear and patent. The patient’s response to stimuli is a valuable indicator for assessing neurological function but does not take precedence over the immediate assessment of the airway when life-threatening issues are at play.