If GCS<8, what is the recommended airway management step?

• A. Nasal cannula oxygen
• B. Oral airway
• C. Establish a definitive airway
• D. Defibrillation

Answer: (C)

When the GCS is less than 8, the patient cannot adequately protect their airway, making obstruction and aspiration big risks. The priority is to secure the airway with a definitive airway so you can protect the airway and provide controlled ventilation.

A nasal cannula oxygen helps only if the patient is breathing and protecting their airway; in a comatose patient that breathing effort may be inadequate, so this option doesn’t reliably protect or ventilate. An oral airway is a helpful temporary adjunct to keep the tongue from blocking the airway, but it does not prevent aspiration and does not provide definitive ventilation support. Defibrillation has no role in airway management. Therefore establishing a definitive airway—typically via endotracheal intubation—is the appropriate next step to ensure airway protection and effective ventilation.