You are working in a pre-hospital setting and are called for a 40-year-old male who was the victim of a stabbing. The patient has a blood pressure of 87/50 and a heart rate of 130. There is a large amount of blood on the scene. After applying direct pressure to the wound on the patient's arm and stopping the bleeding, of the following what would be the best intervention to mitigate the patient's blood pressure?

Correct Answer: D

Rationale: The correct answer is D because in this scenario, the patient is hypotensive (BP 87/50) and tachycardic (HR 130) likely due to hypovolemic shock from blood loss. The goal is to maintain perfusion to vital organs by increasing the blood pressure. Administering fluid to keep the BP at or near 90 systolic is the best initial intervention as it helps restore intravascular volume. Option A (2 liters of fluid) may be excessive without reassessment, potentially leading to fluid overload. Option B (norepinephrine drip) is more appropriate for refractory shock. Option C (dopamine drip) is not the first-line treatment for hypovolemic shock. Thus, option D is the best choice to address the patient's condition effectively.

Correct Answer: D

Rationale: The correct answer is D: Percutaneous peripheral veins in the upper extremities. In a pediatric patient with trauma, percutaneous peripheral veins in the upper extremities are preferred due to easier accessibility, lower risk of complications compared to femoral vein cannulation, less invasive than intraosseous catheter placement, and more practical than saphenous vein cutdown since it allows for rapid IV access. In emergencies, quick and efficient venous access is crucial for administering fluids and medications, making peripheral veins in the upper extremities the preferred choice in this scenario.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. A cross-table lateral x-ray of the cervical spine is crucial for evaluating cervical spine injuries. 2. It allows visualization of all 7 cervical vertebrae and the C-7 to T-1 relationship. 3. This comprehensive view helps in identifying any fractures or dislocations accurately. 4. Missing any part of the cervical spine can lead to overlooking potential injuries. 5. Therefore, ensuring visualization of all 7 vertebrae and the C-7 to T-1 relationship is essential for an accurate assessment. Summary of why other choices are incorrect: - Choice A is incorrect because obtaining the x-ray does not necessarily have to precede endotracheal intubation. - Choice B is incorrect because a cross-table lateral x-ray does not always exclude serious cervical spine injuries; it helps in identifying them. - Choice D is incorrect because even unconscious patients with penetrating cervical injuries may require a cross-table lateral x-ray for accurate

Correct Answer: D

Rationale: The correct answer is D because needle-impenetrable sterile gloves are not minimal precautions for preventing the spread of communicable diseases during resuscitation. Goggles, face mask, and water-impervious gown are necessary to protect against bodily fluids, but needle-impenetrable gloves are not typically required unless there is a specific risk of needlestick injuries. Choosing D would be overkill for minimal precautions.

Correct Answer: C

Rationale: The correct answer is C: Increased cardiac output. Neurogenic shock is characterized by decreased cardiac output due to loss of sympathetic tone. Increased venous capacitance (A) and decreased systemic vascular resistance (B) are features of neurogenic shock due to vasodilation. Warm skin (D) is due to peripheral vasodilation. Therefore, increased cardiac output (C) is not a feature of neurogenic shock.