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. This is true because an emancipated minor is legally recognized as an adult and can make medical decisions without parental consent. Emancipation typically requires a court order that grants the minor the legal status of an adult. In this case, the patient is sixteen and does not need parental consent because she has been granted emancipation by the court. Choice A (implied consent) is incorrect because implied consent generally applies in emergency situations where the patient is unable to provide consent. In this case, the patient is conscious and capable of providing consent. Choice B (not an American citizen) is incorrect because citizenship status does not impact a minor's ability to provide consent for medical treatment. Choice D (orphaned minor living alone) is incorrect because being orphaned does not automatically grant a minor the legal status to make medical decisions without parental consent.

Correct Answer: D

Rationale: The correct answer is D because performing diagnostic peritoneal lavage or a FAST exam is crucial in evaluating for intra-abdominal injuries after blunt trauma. This will help determine if there is internal bleeding or organ damage requiring immediate intervention. A: Performing external fixation of the pelvis is not the immediate priority in this scenario as internal injuries need to be ruled out first. B: Obtaining abdominal and pelvic CT-scans may provide detailed information, but they are time-consuming and not the immediate priority for a potentially unstable patient. C: Performing arterial embolization of the pelvic vessel is not the initial priority as the patient's internal injuries need to be evaluated first.

Correct Answer: D

Rationale: The correct answer is D: Urinary output. Urinary output is the most reliable guide to volume replacement during resuscitation because it directly reflects the perfusion of vital organs and the body's ability to eliminate excess fluid. Adequate urinary output indicates effective fluid resuscitation, while decreased urinary output may indicate inadequate perfusion and the need for further volume replacement. Monitoring urinary output helps ensure appropriate fluid balance and prevents complications such as fluid overload or organ damage. Other choices are not as reliable for volume replacement guidance: A: Heart rate can be influenced by various factors such as pain, stress, medications, and underlying medical conditions. B: Hematocrit reflects the concentration of red blood cells in the blood, which may not accurately reflect volume status during resuscitation. C: Blood pressure can be affected by many factors such as medications, pain, and underlying conditions, making it less reliable as a sole guide for volume replacement.

Correct Answer: B

Rationale: The correct answer is B: Rewarm. The priority for a burn victim with a core temperature of 34°C is to rewarm the body to prevent hypothermia, which can worsen the patient's condition. Escharotomy is a surgical procedure to relieve pressure from burns, not related to temperature. Oxygen mask may be needed but warming is the immediate concern. IV narcotics are not indicated for hypothermia.

Correct Answer: B

Rationale: The correct answer is B: Tilt head and lift chin. This 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 pulled away from the back of the throat, preventing obstruction and allowing for easier breathing. This maneuver helps to maintain a clear airway and facilitates better airflow to the lungs. Other choices are incorrect because: A: "Pull out the tongue" can be dangerous and may cause further obstruction. C: Lifting the neck from behind does not directly address airway obstruction. D: Jaw thrust is a technique used for patients with suspected spinal injuries, not the simplest method for airway management in an unconscious patient.