Final answer:
For a patient responding only to painful stimuli with a clear airway, the initial step is to begin artificial ventilations to maintain adequate oxygenation. Assessing for airway obstruction or need for an OPA or NPA comes after ensuring proper ventilation.
Step-by-step explanation:
If your patient is responsive only to painful stimuli and the airway is clear, the management of the patient's airway depends on their ability to maintain adequate ventilation. In such a case, the logical step is to begin artificial ventilations if you have established that the patient is not breathing adequately on their own. This is imperative to ensure that oxygenation and carbon dioxide removal are maintained. It is important to continuously reassess the patient's airway, breathing, and circulation and to provide Advanced Life Support (ALS) if required and if you're trained to do so.
Options such as suctioning the airway, inserting an Oropharyngeal Airway (OPA), or a Nasopharyngeal Airway (NPA) are considered if there is an obstruction, secretions, or if there is a need to maintain an open airway in an unconscious patient without a gag reflex. Therefore, in the absence of such complications and given the patient's response level, starting with artificial ventilations is crucial until further assessments can guide additional interventions.