A 38-year-old patient is unconscious with slow, shallow, and gasping breaths.

Comprehensive and Detailed Explanation From Exact Extract:

In any unresponsive patient, the first step is to assess and open the airway to determine patency and identify obstruction or inadequate breathing.

Gasping respirations (agonal) are not effective; they require BVM ventilation support. The airway must be open before checking for a pulse or performing auscultation. A secondary assessment is performed only after primary survey and stabilization.