During your primary assessment of a 21-year-old man with a suspected inhalation injury, you note that he is combative and his respirations are profoundly labored and stridorous. The closest appropriate medical facility is approximately 25 miles by ground, and the local air transport service is unavailable. You should:
A) provide supplemental oxygen via nonrebreathing mask, insert an intraosseous catheter, and administer a sedative medication.
B) assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea.
C) administer humidified oxygen, start at least one large-bore IV, and visualize his upper airway to assess the severity of soft-tissue swelling.
D) insert an oropharyngeal airway, ventilate him with a bag-mask device at 20 breaths/min, and prepare to nasotracheally intubate him.
Answer: B) assist ventilations with a bag-mask device, start an IV, administer a sedative and a neuromuscular blocker, and intubate his trachea.
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