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 ET tube). After rapid sequence intubation in an adult with status asthmaticus, albuterol can be administered directly down the endotracheal tube to rapidly dilate the airways. The dose of 2-5 mg is appropriate for adult patients in this situation. Choice A (3 mg of levalbuterol administered directly down the ET tube) is incorrect because levalbuterol is not typically administered directly down the endotracheal tube, and the dose provided is not within the standard range for adult patients. Choice C (2.5 mg of albuterol in 3-mL solution, nebulized and delivered with ventilation) is incorrect because nebulized albuterol may not be as effective in rapidly dilating the airways compared to direct administration down the endotracheal tube in this critical situation. Choice D (

Correct Answer: D

Rationale: The correct answer is D: Initiate full resuscitation efforts including advanced cardiac life support, and contact medical control. Rationale: 1. Patient is pulseless and apneic, indicating cardiac arrest. 2. Legal DNR order does not apply in this scenario as patient's collapse is sudden and not anticipated. 3. The priority is to provide immediate life-saving measures. 4. Advanced cardiac life support increases chances of successful resuscitation. 5. Contacting medical control ensures appropriate guidance and documentation. Summary: A: Waiting for approval could delay critical interventions. B: Stopping resuscitation based solely on the legal DNR order is inappropriate in this emergency. C: Allowing the family to override the legal order puts the patient at risk and is not recommended.

Correct Answer: C

Rationale: The correct next step is to perform endotracheal intubation (Choice C). In this scenario, the patient's presentation with a GCS of 6, dilated pupil, and contralateral weakness indicates significant neurological compromise likely due to increased intracranial pressure. Endotracheal intubation is crucial to protect the airway and ensure adequate oxygenation and ventilation in such critical conditions. Administering medications or performing diagnostic tests like a CT-scan (Choice A), decadron (Choice B), or mannitol (Choice D) should be secondary to securing the airway and stabilizing the patient's condition.

Correct Answer: C

Rationale: The correct answer is C: Severe maxillofacial fractures. These fractures can lead to airway compromise due to obstruction by displaced bone fragments or soft tissue swelling. Definitive airway management is crucial in these cases to ensure adequate oxygenation. Facial lacerations (A) may require suturing but do not necessarily indicate the need for a definitive airway. Repeated vomiting (B) can be managed with positioning and antiemetics, not always requiring an airway intervention. Sternal fracture (D) may cause pain and difficulty breathing but does not directly impede the airway, making it less likely to necessitate definitive airway management.

Correct Answer: C

Rationale: The correct answer is C: Hyperglycemia. In a multisystem injured patient, hyperglycemia is the least likely cause of a depressed level of consciousness because it typically does not directly affect brain function or consciousness. Shock (A), head injury (B), and impaired oxygenation (D) are more likely to cause a depressed level of consciousness in this patient population due to their direct impact on brain perfusion, injury, and oxygen delivery, respectively. Hyperglycemia, although an important consideration in the critically ill patient, is not a primary driver of altered consciousness in the setting of multisystem trauma.