After achieving return of spontaneous circulation, what is your first action?

After achieving return of spontaneous circulation (ROSC), the priority is to ensure that the patient's airway and ventilatory status are adequately assessed. This step is critical because even though the heart has resumed pumping blood, the patient may still be at risk for airway compromise or inadequate breathing. Assessing the airway allows for timely intervention if the patient lacks the ability to protect their airway or requires respiratory support.

In the post-resuscitation phase, patients often have altered levels of consciousness, which can lead to respiratory difficulties. Ensuring that the airway is clear and that the patient is adequately ventilating is essential for maintaining oxygenation and preventing further complications.

While rapid transport to the hospital, reanalyzing the cardiac rhythm, and administering 100% oxygen are all important actions in the broader context of post-resuscitation care, they follow the immediate necessity of confirming that the airway is secure and the patient is breathing adequately. This aligns with standard emergency protocols that prioritize patient safety and effective management of potential complications.