440.A 24-year-old man presents to the ED with diffuse facial pain, pruritus,
erythema, and dizziness after reportedly falling on to an anthill. His initial
vital signs include HR of 102 beats per minute, BP of 118/75 mm Hg, and RR
of 18 breaths per minute with oxygen saturation of 98% on room air. What is the
initial appropriate assessment in this clinical scenario?
a. Give tetanus prophylaxis
b. Begin local wound care
c. Assess airway, breathing, and circulation
d. Start IV fluid administration
e. Give oral antihistamines
441.An undomiciled man of unknown age presents to the ED unresponsive.
His ECG is shown below. What is the most appropriate next step in treatment?
472 Emergency Medicine
IIIIIIV3V2V1V6V5V4aVLaVRaVFa. Defibrillation
b. Cardiac pacing
c. Advanced cardiac life support
d. Advanced cardiac life support and rewarming
e. Cardiopulmonary bypass
(Reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB.Atlas of Emergency
Medicine. New York, NY: McGraw-Hill, 2002: 516.)