In the ABC priority framework, which component is the first priority?

• A. Airway
• B. Breathing
• C. Circulation
• D. Disability

Answer: (A)

Securing the airway is the first priority because oxygen must reach the lungs and be delivered to tissues before you can effectively address breathing or circulation. If the airway is blocked or a patient cannot protect it due to reduced consciousness or facial trauma, hypoxia can develop rapidly and worsen brain injury and other organ damage. In neurologic emergencies, loss of airway reflexes, secretions, edema, or facial injuries can make obstruction even more likely, so securing the airway takes precedence.

Begin by assessing awareness and airway patency, then open the airway with techniques appropriate for suspected spinal injury (for example, a jaw-thrust rather than head-tilt). Clear any secretions, blood, or vomitus with suction, and use airway adjuncts or prepare for advanced airway management if needed. Once the airway is open and protected, you can move on to evaluating and supporting breathing and circulation.