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Administering supplemental oxygen and assessing the situation is critical for a conscious adult experiencing severe respiratory distress. Supplemental oxygen can help alleviate hypoxia and improve oxygenation, which is essential since the patient is conscious and may still be able to maintain some airway reflexes.

The initial assessment allows healthcare providers to evaluate the patient's condition further to determine the underlying cause of the respiratory distress and whether additional interventions are needed. This approach ensures that immediate life-threatening issues are addressed while planning further treatment based on the evolving clinical picture.

Performing immediate intubation may be warranted in cases of unconscious or severely compromised airway management, but it is not the first action for a conscious patient who is still able to maintain some degree of respiratory effort. Transporting the patient to the hospital is important, but without initial stabilization and assessment, it may not be the most effective first step. Initiating chest compressions is reserved for situations where there is a cardiac arrest or severe compromise with no pulse, which does not apply here since the patient is conscious. Thus, administering supplemental oxygen and evaluating the situation is the most appropriate initial action.