An unresponsive 20-year-old male is taking occasional, gasping breaths. What should you do first?

In this scenario, the priority is to initiate chest compressions. When a patient is unresponsive and exhibiting gasping breaths, known as agonal respirations, it indicates a critical state potentially linked to cardiac arrest. These occasional breaths are ineffective for sustaining oxygenation, and immediate action is essential to prevent further deterioration.

Starting chest compressions helps to maintain blood circulation and provides some level of oxygen delivery to vital organs, particularly the heart and brain. It's important to focus on high-quality compressions, which can help improve outcomes until advanced care arrives or the patient can be adequately ventilated.

While other interventions such as attaching an AED or administering naloxone might be necessary later in the treatment sequence, the most immediate and effective action to take in this scenario is to begin chest compressions, as this directly addresses the lack of effective circulation and oxygenation.