The evaluation of a comatose patient with a head injury begins with:

C. Establishment of an airway.

DISCUSSION: The treatment of every comatose patient begins with an assessment of the patient's respiratory system, followed shortly thereafter with an assessment of the patient's cardiovascular system. The unconscious patient's normal protective pharyngeal reflexes are compromised, making mechanical airway obstruction and aspiration pneumonia common events. Hypotension, secondary to intra- or extracorporal hemorrhage, is deleterious to the patient's cerebral injury. Neurologic assessment is undertaken only after the patient's respiratory and cardiovascular status are secured.