You are called to the scene where a 36-year-old male was shot in the back while running away from an assailant. While treating and attempting to stabilize the patient, what should be done with the clothing he was wearing?

Correct Answer: D

Rationale: The correct answer is D. Upon removing the patient's clothing, it should be placed in a paper bag along with the disposable latex gloves used. This is to preserve any potential evidence without contaminating it. Sealing the bag and listing the items ensures a proper chain of custody. Labeling the bag with relevant information helps in tracking and documenting the evidence. This method maintains the integrity of the evidence for forensic analysis. Choice A is incorrect because leaving the clothing on the side may risk contamination or loss of evidence. Choice B is incorrect as placing the clothing between the patient's legs can contaminate or compromise the evidence. Choice C is incorrect as sealing the plastic bag can trap moisture and compromise any biological evidence present.

Correct Answer: B

Rationale: The correct answer is B because in ST-elevation myocardial infarction (STEMI), prompt reperfusion therapy is crucial to minimize cardiac damage. As the patient has ST-elevation on the ECG, this indicates complete occlusion of a coronary artery, necessitating urgent treatment. Fibrinolytics can help dissolve the clot and restore blood flow, but timing is critical. Time is muscle in STEMI, so the door-to-balloon time or door-to-needle time should be minimized. Destination is also important as the patient needs to be transferred to a facility capable of performing percutaneous coronary intervention (PCI) if fibrinolytics are not available. Therefore, choice B is correct. Choices A and D are incorrect because non-ST elevation infarctions do not typically require fibrinolytics, and choice C is incorrect as fluid bolus is not a standard treatment for STEMI.

Correct Answer: A

Rationale: The correct answer is A: Cranial nerve X (vagus). The vagus nerve is responsible for the gag reflex. A loss of gag reflex in a patient with a closed-head and spinal injury indicates damage to the vagus nerve. The other choices are incorrect because: B (oculomotor) is responsible for eye movement, C (hypoglossal) is responsible for tongue movement, and D (glossopharyngeal) is responsible for swallowing and taste sensation. None of these cranial nerves are directly related to the gag reflex.

Correct Answer: C

Rationale: The correct answer is C: Lidocaine. Lidocaine is a Class IB antiarrhythmic drug commonly used for ventricular arrhythmias. In cardiac arrest due to ventricular fibrillation, lidocaine can be a suitable alternative to amiodarone. It works by stabilizing the cardiac cell membrane and reducing electrical activity. Epinephrine (A) is used for its vasopressor effects, not as a first-line antiarrhythmic. Cardizem (B) is a calcium channel blocker used for rate control in certain arrhythmias, not for ventricular fibrillation. Procainamide (D) is a Class IA antiarrhythmic, also used for certain arrhythmias but not typically a first-line choice for ventricular fibrillation in cardiac arrest.

Correct Answer: A

Rationale: Correct Answer: A - Transcutaneous pacing (TCP) Rationale: 1. Atropine failed to increase heart rate, indicating the need for immediate intervention. 2. Transcutaneous pacing is the next step to externally pace the heart and increase heart rate. 3. Synchronized cardioversion (B) is for unstable patients with specific arrhythmias, not for bradycardia. 4. Repeating atropine (C) may not be effective and delays necessary intervention. 5. Epinephrine (D) is typically used in cardiac arrest, not first-line for symptomatic bradycardia.