After intubating your apneic patient, what tube placement confirmation means should be assessed first?

Correct Answer: B

Rationale: The correct answer is B: Attach capnography to determine the presence of ventilatory waveform. Capnography provides immediate feedback on the effectiveness of ventilation, crucial in assessing tube placement. First, confirm if CO2 waveform is present, indicating proper tube placement in the trachea. If waveform absent, reposition tube. Auscultation (Choice A) may not accurately confirm tracheal intubation. End-tidal CO2 detector (Choice C) is efficient but not the first step. Auscultating over the epigastric region (Choice D) is inappropriate for confirming tube placement.

Correct Answer: A

Rationale: The correct answer is A: Mediastinal emphysema. Aortic rupture typically presents with signs like presence of a "pleural cap," obliteration of the aortic knob, and deviation of the trachea to the right. Mediastinal emphysema is not a specific sign of aortic rupture but rather indicates air in the mediastinum, often seen in esophageal rupture or pneumomediastinum. Therefore, in the context of a blunt trauma victim, the presence of mediastinal emphysema is less suggestive of aortic rupture compared to the other signs listed.

Correct Answer: C

Rationale: The correct answer is C: Control internal hemorrhage operatively. In this scenario of a young man with a gunshot wound to the abdomen presenting with cool, diaphoretic skin, confusion, thready pulse, and weak femoral pulse, these are signs of hemorrhagic shock. The definitive treatment for hemorrhagic shock is to control internal bleeding through operative intervention. This is crucial to prevent further blood loss and stabilize the patient's condition. Applying external warming devices (B) or pneumatic anti-shock garment (D) would not address the underlying issue of internal bleeding. Administering blood (A) is important but not the definitive treatment for hemorrhagic shock.

Correct Answer: A

Rationale: The correct answer is A: "Placement of a pelvic binder." In a trauma scenario with hypotension and tachycardia, the priority is to stabilize any potential sources of hemorrhage. Pelvic fractures can lead to significant blood loss, causing hypotension. Placing a pelvic binder helps stabilize the pelvis, reducing the risk of further bleeding and improving hemodynamic stability. This intervention should be done early in the management of trauma patients to prevent worsening shock. Transferring to a trauma center (B) can be considered after initial stabilization. Pelvic x-ray (C) may be needed for definitive diagnosis but is not the immediate priority. Inserting a urinary catheter (D) is not the priority in this scenario and can be delayed until after stabilizing the patient's hemodynamic status.

Correct Answer: D

Rationale: The correct answer is D because delayed symptoms are more common in younger patients due to higher resilience and compensatory mechanisms. Choice A is incorrect as elderly individuals often have decreased circulatory volume. Choice B is incorrect as aging increases the risk of cervical spine degeneration but not necessarily injury risk. Choice C is incorrect as older individuals are more prone to occult fractures due to decreased bone density.