Which of the following would be your most appropriate action after the administration of 1mg of atropine fails to increase the heart rate of your symptomatic bradycardic patient's heart rate and cardiac output?

Correct Answer: A

Rationale: Correct Answer: A - Transcutaneous pacing (TCP) Rationale: 1. Atropine blocks parasympathetic response, so lack of heart rate increase indicates a severe bradycardia. 2. TCP provides immediate pacing to increase heart rate and cardiac output. 3. It is the most appropriate action when medications like atropine fail. 4. Synchronized cardioversion (choice B) is used for unstable tachyarrhythmias, not bradycardia. 5. Repeating atropine (choice C) may not be effective if the initial dose failed. 6. Epinephrine (choice D) is used in cardiac arrest, not as the first-line treatment for symptomatic bradycardia.

Correct Answer: C

Rationale: The Rule of Nines is used to estimate the percentage of body surface area burned. In infants, the head is proportionally larger compared to adults, making it a key area to assess accurately. This is crucial for determining the extent of burns and guiding treatment. Choice C is correct because it highlights the specific anatomical difference in infants. Choices A, B, and D are incorrect as they do not address the unique proportionality of the infant head compared to adults, which is essential in burn assessment for this age group.

Correct Answer: C

Rationale: Step 1: Cerebral edema causes increased intracranial pressure. Step 2: Hypercarbia leads to cerebral vasodilatation. Step 3: Cerebral vasodilatation increases intracranial pressure further. Step 4: Avoiding hypercarbia helps prevent worsening of cerebral edema. Step 5: Therefore, the correct answer is C: Cerebral vasodilatation should be avoided to prevent further increase in intracranial pressure. Summary: - A: Metabolic acidosis is not directly related to hypercarbia in this context. - B: Hypercarbia can lead to respiratory acidosis but it's not the primary concern in cerebral edema. - D: Neurogenic pulmonary edema is not directly caused by hypercarbia in this scenario.

Correct Answer: B

Rationale: The correct answer is B because in a patient with altered consciousness after head trauma, CT scanning is crucial to assess for intracranial injuries. It helps identify any hematomas or contusions requiring urgent intervention. Choice A is incorrect as hyperoxia is beneficial in traumatic brain injury. Choice C is not always necessary if the patient maintains airway patency. Choice D is incorrect as a GCS of 10 suggests moderate head injury, not necessarily severe.

Correct Answer: C

Rationale: The correct answer is C because hypertension following a head injury may indicate imminent herniation from critically high intracranial pressure. Increased blood pressure can worsen intracranial pressure, leading to herniation and further brain damage. Treating hypertension in this scenario is crucial to prevent worsening intracranial pressure and potential herniation. Choices A, B, and D are incorrect as they do not directly address the urgent concern of impending herniation due to high intracranial pressure. Treating hypertension solely to reduce intracranial pressure (A) or assuming pre-existing hypertension (B) may not address the acute issue. Prompt administration of mannitol (D) may not be appropriate without addressing the underlying cause of hypertension and intracranial pressure elevation.