During Case Entry, the patient is awake but not breathing effectively, and the patient is not completely alert. What should the EMD do next?

• A. Move to Key Questions #1 and #2
• B. Shunt to Key Questions #4 and #5
• C. End call and dispatch EMS only
• D. Request medical direction before proceeding

Answer: (B)

The immediate priority is the airway and breathing. When a patient is awake but not breathing effectively and not fully alert, ventilation can fail quickly, so you must jump to the part of the call flow that directly addresses breathing and airway management. Shifting to the questions that handle breathing problems and airway issues allows you to provide the appropriate guidance and trigger EMS without delay, which is essential for this scenario.

Continuing with earlier questions would delay addressing the airway threat, ending the call would leave the patient without needed help, and waiting for medical direction before proceeding could waste critical time. Focusing on the breathing/airway segment ensures you respond to the most life-threatening aspect first.