A 23-year-old man is brought immediately to the ED from the hospitals
parking lot where he was shot in the lower abdomen. Examination
reveals a single bullet wound. He is breathing and has a thready
pulse. However, he is unconsious and has no detectable blood pressure.
Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid
therapy
E. Initiate fluid therapy to return his blood pressure to
normotensive
D. Transfer the patient to the operating room, while initiating fluid
therapy
A 22 year old male present following a motorcycle crash. He complains
of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and
GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray,
pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood pressure does not
respond
E. 1 L of cystalloid and vasopressors if blood pressure does not
respond
Which of the following is MOST RELIABLE to confirm endotracheal
intubation?
a. presence of breath sounds bilaterally
b. absence of borborygmi in the epigatrium on ascultation
c. presence of CO2 in exhaled air via capnography
d. appearance of fog in the endotracheal tube
e. chest xray with endotracheal tube tip appearing above the carina
e. chest xray with endotracheal tube tip appearing above the carina
, A 6 month old infant, being held in her mothers arms, is ejected on
impact from a vehicle that is struck head on by an oncoming car
traveling at 64kph. The infant arrives in the ED with multiple facial
injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her
oxygen saturation is falling. Repeated attempts at orotracheal
intubation are unsuccessful. the most appropriate procedure to
perform next is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation
E. Perform needle cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight,
during which he was beaten with a wooden stick. His chest shows
multiple severe bruises. His arway is clear, resp rate is 22, hear
rate 126, and systolic blood pressure is 90 mmHG. Which of the
following should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam
a. glasgow coma
an 18yo male is brought to the emergency department after being
dumped by a large wave while surfing. He landed head first on the
firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart
rate 60, and respiratory rate 18; he is unable to move his lower
extremities. He appears calm and asks if he will ever walk again. The
most appropriate next step is to:
a. reassure patient that he will walk again
b. proceed to a more detailed neuro exam
c. obtain c spin xrays
d. begin infusion of vasopressors
e. begin bolus of warm IV crystalloid
e. begin bolus of warm IV crystalloid
Whic one of the following statements is true regarding access in
pediatric resuscitation?
a. intraosseous access should be considered only after 5 percutaneous
attempts
b. cutdown at teh ankle is the preferred initial access technique
c. internal jugular cannulation is the next preferred option when
percutaneous venous access fails
parking lot where he was shot in the lower abdomen. Examination
reveals a single bullet wound. He is breathing and has a thready
pulse. However, he is unconsious and has no detectable blood pressure.
Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid
therapy
E. Initiate fluid therapy to return his blood pressure to
normotensive
D. Transfer the patient to the operating room, while initiating fluid
therapy
A 22 year old male present following a motorcycle crash. He complains
of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and
GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray,
pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood pressure does not
respond
E. 1 L of cystalloid and vasopressors if blood pressure does not
respond
Which of the following is MOST RELIABLE to confirm endotracheal
intubation?
a. presence of breath sounds bilaterally
b. absence of borborygmi in the epigatrium on ascultation
c. presence of CO2 in exhaled air via capnography
d. appearance of fog in the endotracheal tube
e. chest xray with endotracheal tube tip appearing above the carina
e. chest xray with endotracheal tube tip appearing above the carina
, A 6 month old infant, being held in her mothers arms, is ejected on
impact from a vehicle that is struck head on by an oncoming car
traveling at 64kph. The infant arrives in the ED with multiple facial
injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her
oxygen saturation is falling. Repeated attempts at orotracheal
intubation are unsuccessful. the most appropriate procedure to
perform next is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation
E. Perform needle cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight,
during which he was beaten with a wooden stick. His chest shows
multiple severe bruises. His arway is clear, resp rate is 22, hear
rate 126, and systolic blood pressure is 90 mmHG. Which of the
following should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam
a. glasgow coma
an 18yo male is brought to the emergency department after being
dumped by a large wave while surfing. He landed head first on the
firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart
rate 60, and respiratory rate 18; he is unable to move his lower
extremities. He appears calm and asks if he will ever walk again. The
most appropriate next step is to:
a. reassure patient that he will walk again
b. proceed to a more detailed neuro exam
c. obtain c spin xrays
d. begin infusion of vasopressors
e. begin bolus of warm IV crystalloid
e. begin bolus of warm IV crystalloid
Whic one of the following statements is true regarding access in
pediatric resuscitation?
a. intraosseous access should be considered only after 5 percutaneous
attempts
b. cutdown at teh ankle is the preferred initial access technique
c. internal jugular cannulation is the next preferred option when
percutaneous venous access fails
