A 25-year-old patient had ingested an unknown quantity of a household cleaner one hour earlier.

The correct answers are A. Prevent hypoxemia and C. Maintain airway patency.

This patient is showing signs of airway compromise:

Swelling around the mouth

Stridor → indicates upper airway obstruction

These findings strongly suggest a caustic ingestion with airway edema, which can rapidly progress to complete airway obstruction.

Priority: Airway and Breathing (ABCs)

According to NREMT principles, the highest priority is airway management and oxygenation.

1. Maintain airway patency (C):

Swelling and stridor indicate a narrowing airway

Immediate action is required to keep the airway open

Prepare for suctioning, positioning, and possible advanced airway support

2. Prevent hypoxemia (A):

Due to airway compromise, the patient is at high risk for inadequate oxygenation

Administer high-flow oxygen and monitor closely

NREMT-aligned guidance states:

“Airway compromise takes priority in caustic ingestions.”

“Stridor indicates impending airway obstruction.”

“Ensure airway patency and adequate oxygenation first.”

Why the other options are incorrect:

B. Identify the chemicalImportant, but not the immediate priority over airway management

D. Irrigate the affected areaMay be appropriate for external exposures, but airway takes priority here

E. Administer activated charcoalContraindicated in caustic ingestions and in patients with airway compromise or vomiting risk

Exact Extracts (NREMT-aligned EMT educational references):

“Airway management is the priority in patients with signs of airway compromise.”

“Stridor is a sign of upper airway obstruction.”

“Do not administer activated charcoal in caustic ingestions.”

Clinical Priority Summary:

Because this patient shows airway swelling and stridor, the EMT must immediately focus on airway patency and oxygenation, making A and C the correct answers.