For a 25-year-old woman with an acute head injury, what should the initial management step be?

In the context of managing a 25-year-old woman with an acute head injury, the initial management step should prioritize ensuring the patient's airway protection and adequate oxygenation. Administering endotracheal intubation is critical when there are indications of potential airway compromise due to altered mental status, unconsciousness, or significant trauma. In cases of head injury, the risk of increased intracranial pressure or airway obstruction can lead to worsened outcomes if the patient cannot maintain their own airway.

Endotracheal intubation ensures that the airway is secured, allowing for controlled ventilation and preventing aspiration. This step is crucial before further diagnostic imaging or definitive therapeutic interventions, such as a CT scan or surgery, can take place. Taking immediate steps to protect the airway is essential in trauma care, aligning with the principles of Advanced Trauma Life Support (ATLS).

While obtaining a CT scan is important for evaluating the extent of the head injury and is typically done soon after intubation, securing the airway takes precedence, especially if there are signs that the patient may not be able to protect it themselves. Other options, like administering medication or performing surgery, would not address the immediate life-threatening risk that airway compromise poses in a trauma setting.