What is the first intervention for severe shortness of breath?

• A. Administer oxygen immediately.
• B. Administer bronchodilator only.
• C. Obtain a chest x-ray.
• D. Perform immediate intubation.

Answer: (A)

When severe shortness of breath is present, the immediate priority is to improve oxygen delivery to the tissues. Administering supplemental oxygen right away addresses hypoxemia and helps relieve the patient’s distress quickly. In the field, this is typically done with a high-concentration device, such as a nonrebreather mask at a high flow, while you monitor the patient’s oxygen saturation and adjust as needed.

Bronchodilators are important for bronchospasm, but they come after you’ve ensured adequate oxygenation. A chest x-ray is useful for diagnosis, but it doesn’t stabilize the patient in acute distress and isn’t an immediate intervention. Intubation is reserved for situations where the patient cannot maintain airway or ventilation despite initial supports.

So the first intervention is to administer oxygen immediately to correct hypoxemia and stabilize the patient.