NRS 427V -Usmle step 3 Q&A - $14.99   Add to cart

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NRS 427V -Usmle step 3 Q&A

NRS 427V -Usmle step 3 Q&A/NRS 427V -Usmle step 3 Q&A. You are called emergently to the medical floor where a 66-year-old man was found to be minimally responsive. His past medical history is unclear but his arm band lists allergies to penicillin and sulfa medications. On arrival, chest compressions are being performed and 2 operators are mask ventilating the patient. Evaluation with an electrocardiogram reveals sinus tachycardia and the diagnosis of pulseless electrical activity is made. Volume is infused and compressions are continued. The patient remains apneic, so mask ventilation continues. During masking, the patient appears to regurgitate large volumes of gastric contents. The most appropriate immediate next step in the management of this patient is to A. cease mask ventilation and suction the mouth B. continue masking the patient C. insert a nasogastric tube D. intubate the trachea and suction the airway E. intubate the trachea and ventilate Explanation: The correct answer is D. Aspiration of gastric contents causes severe lung inflammation. The traditional dogma that the acidic nature of the aspirate is critical has recently been reevaluated and it is now clear that large volumes of gastric contents of any pH are dangerous to the lung. A witnessed aspiration event has the best chances for airway lavage so in these cases an endotracheal tube should be placed, ventilation should be held for a moment, and a flexible suction catheter should be passed so that the airway can be evacuated of gastric contents. B

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