In the emergency department after a house fire, what should the nurse assess first?

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In an emergency department scenario following a house fire, assessing oxygen saturation and the client’s ability to speak is crucial due to potential airway compromise and smoke inhalation. The immediate threat to life in such situations often comes from respiratory issues, particularly if the individual has been exposed to smoke or toxic gases.

A rapid assessment of oxygen saturation provides important information about the patient's respiratory status and the adequacy of oxygenation, which is vital because impaired oxygenation can lead to rapid deterioration. Additionally, the ability to speak indicates whether the airway is patent and functioning; difficulty or inability to speak may suggest significant obstruction or distress.

While assessing burns, vital signs, and pain is important, those evaluations generally follow the urgent assessment of the airway and breathing, as these directly impact survival. Prioritizing the oxygenation and airway allows for prompt interventions, such as administering supplemental oxygen or preparing for potential intubation, that can significantly improve the patient's outcomes in this critical context.

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