A 25-year-old is found unconscious with fever and rash. Which test should be obtained first?

In the scenario presented, the patient is found unconscious and exhibits symptoms such as fever and rash, which may suggest a serious infection or systemic condition. In such critical situations, obtaining blood cultures first is essential. Blood cultures are crucial for diagnosing potentially life-threatening infections, such as sepsis or meningitis. Early identification of the causative organism can significantly improve treatment outcomes and decrease morbidity and mortality.

Establishing the diagnosis promptly allows for the initiation of appropriate antibiotics or interventions which could be critical for the patient's survival. Given the patient's altered level of consciousness, this situation requires immediate attention to potential infectious causes.

While other tests like a basic metabolic panel, arterial blood gases, or blood sugar check can provide valuable information about the patient's metabolic state or respiratory function, they are not as immediately critical as identifying and treating a potential infection. In acute care, prioritizing tests that can lead to rapid diagnosis and treatment of severe conditions is paramount. Thus, starting with blood cultures aligns with this priority.