Your adult status asthmaticus patient requires rapid sequence intubation due to rapidly increasing airway constriction. Which of the following would be most appropriate following tube placement confirmation?

Correct Answer: B

Rationale: The correct answer is B: 2-5 mg of albuterol administered directly down the endotracheal (ET) tube. This is because albuterol is a beta-2 adrenergic agonist that helps to relax bronchial smooth muscles quickly, providing immediate relief in cases of severe airway constriction like in status asthmaticus. Administering it directly down the ET tube ensures rapid delivery to the lungs. Option A is incorrect as levalbuterol is a more potent form of albuterol and may cause adverse effects in high doses. Option C involves nebulizing albuterol which would be slower compared to direct administration. Option D provides a lower dose of levalbuterol, which may not be as effective in a critical situation.

Correct Answer: D

Rationale: The correct answer is D: Initiate full resuscitation efforts including advanced cardiac life support, and contact medical control. In this scenario, the patient is found to be pulseless and apneic with CPR being performed by the family. The legal DNR order is not applicable in this situation as the patient does not have a terminal illness. Therefore, it is crucial to prioritize the patient's immediate need for resuscitation. Initiating full resuscitation efforts, including advanced cardiac life support, is necessary to maximize the chances of survival. Contacting medical control will ensure proper guidance and support during the resuscitation process. Choices A, B, and C are incorrect: A: Contacting medical control and waiting for approval before initiating full resuscitation could delay life-saving interventions. B: Stopping all resuscitation efforts based on the legal DNR order without considering the patient's current condition would be inappropriate. C: Advising the family to stop CPR and explaining the legal D

Correct Answer: C

Rationale: The correct next step is to perform endotracheal intubation (Choice C) in this scenario. Given the presentation of a motor vehicle crash with a GCS of 6, dilated pupil, and contralateral weakness, it indicates severe head trauma causing impending airway compromise and the need for airway protection. Intubation will secure the airway, ensure adequate oxygenation, and prevent the risk of aspiration. Choice A (CT-scan of head) is not the immediate priority as the patient's airway needs to be secured first. Choice B (Decadron) is not indicated for acute head trauma and may even worsen brain injury. Choice D (Mannitol) may help reduce intracranial pressure, but securing the airway takes precedence in this critical situation.

Correct Answer: C

Rationale: Correct Answer: C - Severe maxillofacial fractures Rationale: 1. Severe maxillofacial fractures can compromise the airway due to obstruction or displacement of structures. 2. Airway management is crucial in trauma patients to ensure adequate oxygenation and ventilation. 3. Maxillofacial fractures can lead to airway compromise rapidly, requiring a definitive airway intervention. 4. Other choices (A: Facial lacerations, B: Repeated vomiting, D: Sternal fracture) may not directly impact the airway to the same extent as severe maxillofacial fractures.

Correct Answer: C

Rationale: The correct answer is C: Hyperglycemia. In a multisystem injured patient, the primary causes of depressed consciousness are related to perfusion and oxygenation. Hyperglycemia, while a concern, is less likely to directly cause a depressed level of consciousness compared to shock, head injury, and impaired oxygenation. Hyperglycemia may lead to symptoms like confusion or weakness, but it typically does not result in a significant decrease in consciousness level. Therefore, in the context of a multisystem injured patient, hyperglycemia is the least likely cause of a depressed level of consciousness.