You are transporting a 32-year-old male involved in a high-speed motor vehicle collision who presents with a Glasgow Coma Scale (GCS) score of 6, unequal pupils, and hypotension. The patient shows signs of decerebrate posturing. What is the most critical initial intervention you should perform?
Maintaining adequate oxygenation is the most critical intervention for a patient with a traumatic brain injury showing signs of increased intracranial pressure and poor neurological status. Hypoxia can exacerbate brain injury, so ensuring the patient has an adequate airway and is well oxygenated is vital. While administering hypertonic saline and reducing intracerebral pressure are important, they come after ensuring adequate oxygenation and airway protection.
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