You are on-scene with a cardiac history patient experiencing unstable ventricular tachycardia that is not responding well to prehospital interventions. The patient and family want the patient transported to a hospital across town; however, there is a facility more capable of handling the cardiac event much closer. Which of the following would be most appropriate?

Correct Answer: C

Rationale: Rationale for Correct Answer C: 1. Safety: Transporting to the closer facility will reduce transport time, critical for unstable ventricular tachycardia. 2. Medical benefit: The closer facility is more capable, providing better care for the cardiac event. 3. Informed decision: Explaining the situation to the patient and family ensures understanding and involvement in the decision-making process. 4. Patient-centered care: Transporting to benefit the patient's health is the priority. Summary of Incorrect Choices: A: Delaying transport to explain at the farther facility risks the patient's health. B: Prioritizing patient preference over medical necessity can endanger the patient. D: Disregarding medical expertise and patient safety in favor of family choice is inappropriate.

Correct Answer: D

Rationale: The correct answer is D: Naloxone. Meperidine hydrochloride is an opioid analgesic, and naloxone is an opioid antagonist that can reverse opioid overdose effects by competing for opioid receptor sites. Step 1: Identify the medication ingested (meperidine). Step 2: Recognize that meperidine is an opioid. Step 3: Understand that naloxone is an opioid antagonist that can reverse opioid effects. Step 4: Administer naloxone to competitively block opioid receptors and reverse the adverse effects. Activated charcoal (A) is used for certain poisonings, not opioids. Atropine (B) is a medication used for bradycardia and not effective for opioid overdose. Romazicon (C) is a benzodiazepine receptor antagonist, not indicated for opioid overdose.

Correct Answer: C

Rationale: The correct answer is C: Directly into the vallecula. Placing the tip of the curved Macintosh blade directly into the vallecula allows for optimal visualization of the glottis during intubation. By lifting the epiglottis indirectly, the blade creates space for passage of the endotracheal tube. Placing the blade directly under the epiglottis (A) may obstruct the view. Placing it in the space below the vallecula (B) may not provide sufficient elevation. Placing the blade directly on the epiglottis (D) can cause trauma and obstruct the view.

Correct Answer: C

Rationale: Step 1: Establishing a diagnosis of shock involves assessing for clinical evidence of inadequate organ perfusion, such as altered mental status, tachycardia, and cool clammy skin. Step 2: This clinical evidence is crucial as it indicates the body's organs are not receiving enough oxygen and nutrients due to poor perfusion. Step 3: Identifying inadequate organ perfusion helps differentiate shock from other conditions with similar symptoms. Step 4: The other choices are incorrect because systolic blood pressure alone is not sufficient for diagnosing shock (A), closed head injury is not a defining feature of shock (B), and response to fluid infusion is important but not the sole criterion (D). Summary: Choice C is correct as it focuses on the key clinical feature of inadequate organ perfusion, while the other choices either focus on single parameters or unrelated conditions.

Correct Answer: C

Rationale: The correct answer is C: Breath sounds. In cardiac tamponade, there may be muffled or distant heart sounds due to the accumulation of fluid around the heart, impacting its ability to pump effectively. In tension pneumothorax, breath sounds may be absent or decreased on the affected side due to lung collapse. This differentiation is important as cardiac tamponade requires emergent pericardiocentesis, while tension pneumothorax necessitates needle decompression. Choices A, B, and D are not as useful in differentiating between the two conditions. Tachycardia may be present in both conditions, pulse volume may be decreased in both, and pulse pressure may be narrowed in both due to decreased cardiac output. Breath sounds are a key differentiating factor in this scenario.