Nevada Funeral Arranger Practice Exam

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A 24-year-old male was involved in a high-speed motor vehicle collision. He is unresponsive, has shallow respirations at 8 breaths per minute, and a palpable radial pulse of 120 bpm. His pupils are unequal, and he has decerebrate posturing. What is the most critical immediate intervention?

Initiate rapid fluid resuscitation with 2 liters of normal saline. Perform a rapid trauma assessment and apply a cervical collar. Secure the airway with an advanced airway device and assist ventilations. Administer a bolus of 50% dextrose to rule out hypoglycemia.

Correct Answer:

Secure the airway with an advanced airway device and assist ventilations.

Explanation:

The patient's shallow respirations and decreased respiratory rate indicate impending respiratory failure. Securing the airway with an advanced airway device and assisting ventilations is the most critical immediate intervention to ensure adequate oxygenation and ventilation, especially in a patient with signs of severe head injury. While a rapid trauma assessment and cervical collar are important, airway management takes precedence. Fluid resuscitation should be judicious in head trauma to avoid increasing intracranial pressure, and dextrose is not the primary intervention here.

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