Questions: A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70 / 50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes: Select one: A. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B. assisted ventilation, preventing hyperthermia, and elevating his lower extremities. C. oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D. assisted ventilation, thermal management, and elevation of the lower extremities.

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70 / 50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

Select one:
A. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head.
B. assisted ventilation, preventing hyperthermia, and elevating his lower extremities.
C. oxygen via nonrebreathing mask, thermal management, and elevation of his legs.
D. assisted ventilation, thermal management, and elevation of the lower extremities.

Transcript text: A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is $70 / 50 \mathrm{~mm} \mathrm{Hg}$, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes: Select one: A. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B. assisted ventilation, preventing hyperthermia, and elevating his lower extremities. C. oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D. assisted ventilation, thermal management, and elevation of the lower extremities.

Solution

The answer is D: assisted ventilation, thermal management, and elevation of the lower extremities.

Explanation for each option:

A. Oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head.

Incorrect: While providing oxygen and thermal management is appropriate, elevating the head is not recommended in this scenario, especially with a suspected spinal injury.

B. Assisted ventilation, preventing hyperthermia, and elevating his lower extremities.

Incorrect: Preventing hyperthermia is not the primary concern here; rather, maintaining normal body temperature is important. Assisted ventilation and elevating the lower extremities are correct actions.

C. Oxygen via nonrebreathing mask, thermal management, and elevation of his legs.

Incorrect: While oxygen and thermal management are appropriate, the patient may require more than just oxygen via a mask due to his rapid, shallow respirations. Assisted ventilation is more suitable.

D. Assisted ventilation, thermal management, and elevation of the lower extremities.

Correct: Assisted ventilation is necessary due to the patient's rapid, shallow respirations. Thermal management is important to prevent shock, and elevating the lower extremities can help improve blood pressure in cases of shock.

In summary, the most appropriate treatment for this patient, given his condition, includes assisted ventilation, thermal management, and elevation of the lower extremities to address potential shock and respiratory issues.

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