Pre-Quiz: Spinal cord injury

A 20-year-old patient with similar symptoms is brought in by EMS due to a gunshot wound to the abdomen. The patient is bleeding excessively. His vitals are as follows: BP 90/40s, HR 136, RR 28, O2 94% on 2L, and temperature: 98.6°F. He is 80 kg. The patient is in a lot of pain and is agitated. He is able to follow some commands but EMS states that he has become less responsive as time has gone on. His FAST exam is positive with blood in the abdomen. Which of the following interventions will ultimately help to save the patient?

A 45-year-old male, with a medical history of hypertension and diabetes, is rushed to the emergency department following a vehicle collision. He complains of a headache, nausea, and difficulty catching his breath. A Glasgow Coma Scale assesses him a score of 11. A CT scan also reveals elevated intracranial pressure. Which of the following systemic factors is most likely contributing to the patient’s raised intracranial pressure?

A 32-year-old female patient presents with a recently-dislocated left shoulder after playing soccer and extending her arm to block a shot. Her team’s medical staff successfully performed a reduction of the dislocation on the spot. In a separate scenario, a 65-year-old hunter is brought to the emergency room with a gunshot wound to his right leg caused by friendly fire, and you suspect a Gustilo-Anderson Type III fracture. You elect to administer cefazolin and aminoglycosides as preventative antibiotics. According to the EAST criteria, for how long should antibiotics be continued for the hunter’s open fracture?

A 34-year-old male warehouse employee presents to the ER following a cylinder explosion. He was standing 5 meters away from the explosion. On examination, he has a 13cm contaminated wound with significant soft tissue injuries and a fractured tibia caused by high-velocity metal fragments. In which open fracture classification, according to the Modified Gustilo Anderson categories, would you place the patient?

A 32-year-old male is brought in by emergency medical services after sustaining severe burns from a fire-related incident. The estimated total body surface area (TBSA) burn is about 30%. His presenting vital signs are as follows: blood pressure 65/40 mmHg, heart rate 136 beats/min, and respiratory rate 25 breaths/min. He appears pallid and finding pedal pulses is challenging.

What should be your initial action in managing this patient?