You are on-scene with a patient who was struck by a car on her bicycle. She is conscious and alert but has a possible closed right mid-shaft femur fracture. The patient advises you that she is sixteen but does not need parental consent to be treated. Which of the following situations would make this statement true?

Correct Answer: C

Rationale: The correct answer is C: She is an emancipated minor granted by the court. An emancipated minor is legally considered an adult and can make medical decisions without parental consent. This situation would make the statement true because an emancipated minor has the legal authority to consent to their own treatment. Rationale: 1. Emancipated minors are legally recognized as adults in terms of making medical decisions. 2. Emancipation grants the minor the right to make healthcare choices independently. 3. In this scenario, the patient being an emancipated minor means she can consent to treatment without involving her parents. Summary of other choices: A: Implied consent does not apply in this scenario as the patient is conscious and alert, and the injury is not immediately life-threatening. B: Immigration status is not relevant to the patient's ability to consent to treatment without parental consent. D: Being an orphaned minor does not automatically grant the ability to consent to treatment without parental consent.

Correct Answer: D

Rationale: The correct answer is D: Perform diagnostic peritoneal lavage or FAST. This is the priority in trauma management to assess for intra-abdominal injuries like bleeding. External fixation (A) is for stabilizing pelvic fractures, not a priority. Abdominal and pelvic CT-scans (B) and arterial embolization (C) are not immediate actions and may delay crucial interventions. Diagnostic peritoneal lavage or FAST (D) are rapid and effective methods to detect intra-abdominal bleeding in trauma patients.

Correct Answer: D

Rationale: The correct answer is D: Urinary output. This is because urinary output is a direct indicator of kidney perfusion and function, reflecting the body's response to volume status. Increasing urinary output suggests adequate volume replacement, while decreasing output may indicate hypovolemia. Heart rate, hematocrit, and blood pressure can be influenced by various factors and may not always accurately reflect volume status. Urinary output is considered the most reliable guide to volume replacement during resuscitation as it provides real-time feedback on kidney perfusion and fluid balance.

Correct Answer: B

Rationale: The correct next step is to rewarm the burn victim with a core temperature of 34°C. Hypothermia increases mortality in burn patients. Rewarming is crucial to prevent further complications. Escharotomy is for circulation issues, oxygen mask for respiratory problems, and IV narcotics for pain management, but rewarming takes priority in this scenario to stabilize the patient's core temperature.

Correct Answer: B

Rationale: The correct answer is B: Tilt head and lift chin. This technique, known as the head-tilt chin-lift maneuver, is the simplest and most effective way to open the airway in an unconscious patient. By tilting the head back and lifting the chin, the tongue is moved away from the back of the throat, allowing for better airflow. This maneuver helps prevent airway obstruction and facilitates breathing. Explanation of why other choices are incorrect: A: "Pull out the tongue" - This is incorrect as it can potentially cause harm by pushing the tongue back further and obstructing the airway. C: Lift neck from behind - This is incorrect as it can cause further injury to the neck and spine of an unconscious patient. D: Jaw thrust - While jaw thrust is another technique used to open the airway, it is more complex and requires training to perform correctly, making it less simple than the head-tilt chin-lift maneuver.