On admission to the emergency department, the patient is unconscious after suspected overdose of sleeping pills. The patient's temperature is 98, pulse is 60, respirations are 10, and blood pressure is 90/50. Pupillary reflexes are sluggish. What is the initial action of the ED nurse?

A. Determine disability using the Glasgow Coma Scale: Assessing neurologic status with the Glasgow Coma Scale is important, but it is secondary to ensuring airway, breathing, and circulation. Immediate airway management takes priority in an unconscious patient with hypoventilation. B. Obtain laboratory tests: Laboratory tests help identify the toxic agent and guide treatment, but collecting labs does not address the immediate life-threatening risk of hypoxia from inadequate ventilation. C. Administer a central nervous system stimulant: Giving a CNS stimulant is not a safe or standard intervention for sedative overdose. Stimulants do not reverse respiratory depression and could worsen cardiovascular instability. D. Maintain a patent airway: The patient’s respiratory rate is critically low (10 breaths/min), indicating hypoventilation and risk of hypoxia. Securing and maintaining a patent airway is the highest priority to ensure oxygenation and prevent respiratory arrest, following the ABCs of emergency care.