In a patient with severe upper abdominal pain and vomiting blood, what is your most immediate action?

In a scenario where a patient presents with severe upper abdominal pain and is vomiting blood, the most immediate action is to protect her airway from aspiration. This is crucial because the presence of blood in the vomitus significantly increases the risk of aspiration, which can lead to serious complications such as airway obstruction or aspiration pneumonia. By ensuring that the airway is protected—through positioning or suctioning of the airway if necessary—the EMT can help maintain ventilation and prevent further harm to the patient.

While other measures, such as keeping the patient supine and warm or providing oxygen, are also important, they are secondary to airway protection. Rapid transport is critical in emergencies, but if the airway is compromised or at risk, it must be addressed first to ensure the patient can breathe effectively during transport. Protecting the airway establishes a foundation for further treatment and transport to a higher level of care.