What can the paramedic expect to find when evaluating the pupillary response of a patient suspected of suffering from herniation?

Correct Answer: A

Rationale: The correct answer is A: Bilateral pupil dilation. In cases of herniation, increased intracranial pressure can lead to compression of the cranial nerves, resulting in bilateral pupil dilation. This is known as the "blown pupil" sign. Unilateral, unequal, or non-reactive pupils (Choice B) could indicate other issues like trauma or nerve damage. Bilaterally unequal and non-responsive pupils (Choice C) are not typical of herniation. Sluggish response with equal pupils (Choice D) may suggest a different neurological condition but not specifically herniation.

Correct Answer: C

Rationale: The correct answer is C: Directly into the vallecula. Placing the tip of the Macintosh blade directly into the vallecula helps lift the epiglottis and provides a clear view of the vocal cords during intubation. Placing it under the epiglottis (choice A) may obstruct the view. Placing it below the vallecula (choice B) may not provide adequate elevation. Placing it directly on the epiglottis (choice D) may cause trauma and difficulty in visualizing the glottis.

Correct Answer: C

Rationale: The correct answer is C. Clinical evidence of inadequate organ perfusion must be present to establish a diagnosis of shock. This is because shock is characterized by inadequate tissue perfusion leading to organ dysfunction. It is a state of systemic hypoperfusion resulting in cellular and metabolic imbalances. A is incorrect because a specific systolic blood pressure cutoff alone is not sufficient to diagnose shock. B is incorrect as the presence of a closed head injury is not a requirement for diagnosing shock. D is incorrect because a lack of response to intravenous fluid infusion is not the sole criteria for diagnosing shock.

Correct Answer: C

Rationale: The correct answer is C: Breath sounds. In cardiac tamponade, there may be muffled heart sounds and distant or absent breath sounds due to the accumulation of fluid around the heart, compressing the lungs. This differentiates it from tension pneumothorax, where there is hyperresonance to percussion and decreased or absent breath sounds on the affected side. A: Tachycardia is a common feature of both cardiac tamponade and tension pneumothorax, so it does not differentiate between the two conditions. B: Pulse volume may be decreased in both cardiac tamponade and tension pneumothorax, so it is not the best differentiator. D: Pulse pressure may be narrowed in both conditions, so it is not the most specific differentiating factor.

Correct Answer: D

Rationale: Performing lower extremity fasciotomies is the correct choice in this scenario because the prolonged entrapment of the leg can lead to compartment syndrome, a condition where increased pressure within the muscles compromises blood flow, risking limb loss. Fasciotomies involve making incisions to release the pressure and restore circulation, thus improving chances of limb salvage. Applying skeletal traction (A) may help stabilize the leg but won't address the underlying issue of compromised blood flow. Administering anticoagulant drugs (B) is not directly relevant to the treatment of compartment syndrome. Administering thrombolytic therapy (C) is used for dissolving blood clots and is not indicated in this case.