You are on-scene with a patient suspected of taking a large amount of meperidine hydrochloride. Which of the following interventions may be effective in reversing the adverse effects of the ingested medication?

Correct Answer: D

Rationale: The correct answer is D: Naloxone. Meperidine hydrochloride is an opioid analgesic that can cause respiratory depression. Naloxone is an opioid antagonist that can reverse the respiratory depression caused by opioid overdose by competitively binding to opioid receptors. Administering naloxone can quickly reverse the adverse effects of meperidine overdose and restore normal respiratory function in the patient. Activated charcoal (A) is used to absorb toxins in the gastrointestinal tract but is not effective in reversing the effects of opioids. Atropine (B) is an anticholinergic drug used to treat bradycardia and not effective in reversing opioid overdose. Romazicon (C) is a benzodiazepine antagonist and not effective in reversing opioid overdose. In summary, naloxone is the correct intervention for reversing the adverse effects of meperidine hydrochloride overdose due to its opioid antagonist properties, while the other choices are not effective in this specific scenario

Correct Answer: D

Rationale: The correct answer is D. In a trauma scenario like a gunshot wound to the lower abdomen, the priority is to transfer the patient to the operating room for surgical exploration and intervention. This is because penetrating abdominal injuries often require urgent surgical exploration to identify and control bleeding, repair organ damage, and prevent complications like peritonitis. Initiating fluid therapy is crucial to stabilize the patient's hemodynamic status. Performing a diagnostic peritoneal lavage (choice A) is outdated and has been replaced by more advanced imaging techniques. Infusing packed red blood cells (choice B) can be done after stabilizing the patient in the operating room. Inserting a nasogastric tube and urinary catheter (choice C) is not the immediate priority in this critical situation.

Correct Answer: D

Rationale: The correct answer is D: Maintain inline immobilization and establish a definitive airway. In a trauma patient with inspiratory stridor and a suspected C-spine injury, maintaining inline immobilization is crucial to prevent worsening of the spinal injury. Establishing a definitive airway is necessary to secure the patient's airway and improve oxygenation. Immediate tracheostomy (choice B) is too invasive and carries risks. Applying cervical traction (choice A) can worsen the C-spine injury. Inserting bilateral thoracostomy tubes (choice C) is not indicated for a patient with stridor and a C-spine injury.

Correct Answer: D

Rationale: The correct answer is D: Transfer the patient to a neurosurgeon without performing a CT-scan. Rationale: 1. The patient has sustained significant head trauma with neurological symptoms. 2. The patient is not responding to verbal stimuli but localizes to painful stimuli, indicating altered mental status. 3. There is no neurosurgeon at the local hospital, suggesting the need for transfer to a facility with neurosurgical capabilities. 4. Performing a CT-scan may delay necessary intervention, and in this case, immediate neurosurgical evaluation is crucial. Summary: A: Admitting the patient for observation is not appropriate as she requires specialized care. B: Obtaining x-ray of facial bones is not a priority in this scenario and does not address the potential neurological injury. C: While a complete x-ray evaluation of the cervical spine is important, neurosurgical evaluation takes precedence in this case to assess for possible intracranial injuries.

Correct Answer: D

Rationale: The correct answer is D. Applying oxygen and maintaining airway is the first step in treatment for an unresponsive patient to ensure proper oxygenation and ventilation. This step is crucial in preventing hypoxia, which can lead to further complications. Administering vasopressors (choice A) is not necessary initially as the priority is airway management. Establishing IV access for drug-assisted intubation (choice B) is premature without ensuring adequate oxygenation first. Seeking the cause of decreased level of consciousness (choice C) can be done after ensuring airway patency and oxygenation.