In the initial assessment for a patient with slow pulse, respirations, and low BP, what is the first priority in the primary assessment?

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Securing a patent airway is the first priority in the primary assessment. When a patient presents with a slow heart rate, slow or shallow breathing, and low blood pressure, the risk of hypoxia is immediate. If the airway is obstructed or not functioning, you cannot adequately assess or support breathing, and tissues won’t receive enough oxygen no matter what you do to circulation. So you first open and protect the airway—use airway maneuvers appropriate for the situation, clear secretions with suction, and insert an airway adjunct or provide advanced airway support if needed, while delivering oxygen as available. Only after the airway is secure do you move on to breathing support and then circulation.

History-taking and transport come after airway and breathing are addressed, and fluids are considered once airway patency and ventilation are stabilized, since giving fluids without first securing the airway could worsen risk if the patient cannot protect the airway or ventilate effectively.