What is the first action you should take for an obese patient with a GCS of 8 requiring a CT scan?

In the scenario presented, where the patient has a Glasgow Coma Scale (GCS) of 8 and is obese, the foremost priority is to secure the airway to ensure the patient can breathe adequately. A GCS of 8 indicates that the patient is in a state of severe impairment of consciousness and is at a high risk for airway compromise due to potential loss of protective reflexes and decreased responsiveness.

Inserting a definitive airway, typically through endotracheal intubation, is essential to maintain airway patency, particularly in an obese patient who may have increased challenges related to airway anatomy and respiratory mechanics. The risk of respiratory depression or failure is heightened in this group, making it critical to secure the airway before proceeding to imaging studies like a CT scan, which may require the patient to be in a specific position for an extended time.

Following airway management, additional assessments, such as obtaining cervical spine imaging or administering sedatives, can be addressed. However, they are secondary to the immediate need for securing the airway, which ensures the patient remains stable for further evaluation and treatment.