Pre-Quiz: Trauma Resuscitation

A 42-year-old male patient arrives at emergency following a serious road accident. He exhibits symptoms of severe neck pain, reduced mobility in his limbs, bradycardia with a heart rate of 55 beats/minute, and hypotension with a systolic blood pressure of 85 mm Hg. He has a known medical history of hypertension, which is managed with regular medication. Based on the symptoms and his condition, the diagnosing physician suspects that he may have sustained an injury to his spinal cord, leading to neurogenic shock.

What is the optimal target mean arterial pressure for a patient diagnosed with neurogenic shock?

A 35-year-old male patient presents to the emergency department following a severe car accident. He has sustained multiple injuries, and you suspect he might be experiencing internal bleeding. Which of the following parameters should be used to assess whether the patient needs fluid resuscitation?

A 33-year-old male, with no history of chronic diseases, falls from the roof of his house. He is complaining of severe neck and back pain at the Emergency Department (ED), where spinal instability is suspected. His blood pressure is 70/40mmHg, pulse is at 55 bpm, his respiratory rate is 30bpm, and his oxygen saturation is 90% at room air. A cervical CT scan reveals a C5 vertebral fracture, and a diagnosis of neurogenic shock is considered.

In light of these findings, which of the following best describe the clinical features of neurogenic shock?

A 75-year-old male patient has been brought into the emergency department after a fall at his home. Initial assessment reveals him to be conscious but reporting significant dizziness. EMS initiated an IV line in transit and he received a 2-liter bolus of normal saline. On arrival, his blood pressure is 80/60 mmHg, pulse is 130 beats/min, and body temperature is 37.5C. His jugular veins appear flat and the capillary filling time is more than 3 seconds. Vascular parameters have been measured revealing a low Cardiac Index, low Pulmonary capillary wedge pressure (PCWP), but high Systemic vascular resistance.

Based on the findings, which of the following is the most probable diagnosis?

A 55-year-old man with a history of type I diabetes and hypertension presents after stepping on a nail while cleaning his yard. He was unable to remove the nail or his shoe, prompting him to seek medical attention. The patient is poorly adherent to his medications and has a history of anaphylaxis to fluoroquinolones. His temperature is 100°F (37.8°C), blood pressure is 179/102 mmHg, pulse is 101/min, respirations are 15/min, and oxygen saturation is 99% on room air. After removing the 4 cm nail, his shoe, and sock, the foot and wound are rinsed thoroughly. The patient is given a tetanus vaccine and 1 dose of vancomycin. Which of the following is the most appropriate antibiotic regimen for this patient?