What should a paramedic assess first in a patient with difficulty breathing?

In emergencies involving patients with difficulty breathing, assessing airway patency is critical, as the airway is essential for adequate ventilation and oxygenation. If the airway is compromised—whether due to obstruction, swelling, or other factors—subsequent assessments may be futile if the patient cannot receive oxygen effectively. Ensuring that the airway is clear allows for proper assessment and management of the patient's respiratory difficulties and overall condition.

Monitoring heart rhythm, lung sounds, and vital signs are important parts of the clinical picture, but these assessments rely on a patent airway to provide accurate and meaningful results. Without ensuring the airway is open and clear, other assessments can be misleading, and appropriate interventions might be delayed. Therefore, airway patency is the first priority in evaluating a patient who is experiencing respiratory distress.