Continued Scene Assessment

1
Continued Scene Assessment
The driver is extricated and immobilized. Blood
pressure 100/P, HR 128 bpm, RR 28/min, SaO2 90
on 100 oxygen. No other injuries are identified,
but breath sounds are ?? on the left. ACLS
arrives. What should be done first?

1. Perform rapid sequence intubation
2. Do needle thoracentesis of the left chest
3. Transport to nearest hospital (5 minutes)
4. Transport to trauma center (15 minutes)

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2
ED Assessment
You confirm decreased breath sounds in the left
chest and observe JVD. As you listen to the
heart, a bradycardia develops, and SaO2 falls to
78. BP is absent, RR agonal. What should you do
now?

1. Give atropine, then epinephrine
2. Place an advanced airway
3. Perform needle decompression of the left thorax
4. Perform pericardiocentesis

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