What initial action should be taken for a patient who is unresponsive, not breathing, but has a strong pulse?

In the scenario where a patient is unresponsive, not breathing, but has a strong pulse, the priority is to ensure the airway is clear and that the patient can breathe effectively. The initial action of opening the airway via a head tilt-chin lift or jaw thrust is essential. This maneuver helps to prevent airway obstruction, which can occur if a patient's tongue falls back or if there are other obstructions present due to their unresponsive state.

While initiating chest compressions or administering epinephrine may be appropriate in other situations, such as in cases of cardiac arrest or anaphylaxis, these actions are not indicated here because the patient still has a strong pulse. The presence of a pulse indicates that the heart is still functioning, and immediate chest compressions would not be warranted.

Beginning rescue breaths without oxygen also would not be the best initial approach, as the priority is to ensure the airway is patent before providing any form of ventilation. Therefore, opening the airway helps to prepare for potential rescue breaths and overall offers the best chance for the patient to resume effective breathing.