An unresponsive near-drowning patient has a pulse but no respirations. What is the best way to manage the airway?

In the scenario presented, the best way to manage the airway of an unresponsive near-drowning patient who has a pulse but no respirations is to use a jaw-thrust maneuver, insert an oral airway, and employ a bag-valve mask.

The jaw-thrust maneuver is particularly effective in patients who are unresponsive, as it helps to open the airway by moving the jaw forward while minimizing the risk of further airway obstruction from the tongue. An oral airway can then be used to further secure the airway, ensuring that it remains open and unobstructed. Lastly, using a bag-valve mask allows for positive pressure ventilation, delivering oxygen directly to the patient's lungs, which is critical since the patient is not breathing.

This approach is essential in any case of respiratory arrest, especially in near-drowning situations, as the priority is to restore adequate ventilation. Immediate ventilation supports can prevent brain hypoxia and improve the chances of survival.

Other methods, such as mouth-to-mouth resuscitation, may not be as effective in emergency situations due to potential barriers, including the unresponsiveness and potential risk of further complications. Supplemental oxygen alone, while beneficial, does not address the need for ventilatory support, which is critical here. Initiating chest