An 18-year-old male with altered level of consciousness starts to vomit after you ventilate him during transport. What should you do?

In the scenario where an 18-year-old male with altered level of consciousness begins to vomit during transport, rolling him on his side is the most appropriate action. This maneuver helps to prevent aspiration of vomit into the lungs, which can lead to severe complications such as aspiration pneumonia. Positioning the patient on his side allows vomit to exit the mouth without obstructing the airway, thereby maintaining a clear airway and facilitating effective ventilation while minimizing the risk of aspiration.

While suctioning the mouth may seem like a viable option, this could be more time-consuming and may not be as immediately effective in preventing aspiration as rolling the patient onto his side. Continuing ventilation in the presence of vomiting increases the risk of aspirating the vomit into the lungs, which can compromise respiratory function. Inserting an oropharyngeal airway may also not be appropriate if the patient is actively vomiting, as it could stimulate further vomiting or make the situation worse if not positioned correctly. Thus, rolling the patient on his side is the most suitable immediate response to ensure airway safety and prevent aspiration during the episode of vomiting.