Your patient is a 21-year-old man with a single, small-caliber gunshot wound to the left anterior chest, just lateral to the sternum at the fourth intercostal space. Bleeding from the wound is minimal. The patient is initially anxious, combative, and diaphoretic. Initial vital signs include a heart rate of 100, respirations of 20, and a blood pressure of 110/80. Breath sounds are clear
bilaterally and equal. En route, the patient becomes quieter but still restless. The heart rate increases to 120, respirations are 24, blood pressure 106/88, and breath sounds remain clear and equal. The patient has also developed significant JVD. You are 15 minutes from a Level I trauma center and 5 minutes away from a large community hospital. You should:
A) immediately decompress the left chest and divert to the community hospital for chest tube insertion.
B) immediately decompress the left chest and continue to the trauma center for chest tube insertion.
C) continue to the Level I trauma center for pericardiocentesis.
D) divert to the community hospital for pericardiocentesis.
D
You might also like to view...
Third-party payers are entities other than the physician or patient who pay for healthcare services. What percentage of healthcare services in the United States is paid by third-party payers?
a. 83% b. 79% c. 86% d. 90%
Which of the following physiologic changes occur during sleep? Colonic motility is decreasedPenile tumescence occurs during REMPlasma growth hormones peak during Stage N3The heart rate can increase by up to 35% during REMCerebral blood flow decreases during non-REM sleep
A. II, III, and V only B. I, III, V only C. I, II, III, IV, and V D. I, II, III only