130.A 20-year-old man presents to the ED with multiple stab wounds to
his chest. His BP is 85/50 mm Hg and HR is 123 beats per minute. Two
large-bore IVs (intravenous) are established and running wide open. On
examination, the patient is mumbling incomprehensibly, has good air entry
on lung examination, and you notice jugular venous distension. As you are
listening to his heart, the nurse calls out that the patient has lost his pulse
and that she cannot get a BP reading. Which of the following is the most
appropriate next step in management?
a. Atropine
b. Epinephrine
c. Bilateral chest tubes
d. ED thoracotomy
e. Pericardiocentesis
131.A 22-year-old man calls the ED from a local bar stating that he was
punched in the face 10 minutes ago and is holding his front incisor tooth
in his hand. He wants to know what is the best way to preserve the tooth.
Which of the following is the most appropriate advice to give the caller?
a. Place the tooth in a napkin and bring it to the ED
b. Place the tooth in a glass of water and bring it to the ED
c. Place the tooth in a glass of beer and bring it to the ED
d. Pour some water over the tooth and place it immediately back into the socket
e. Place the tooth in a glass of milk and bring it to the ED
132.A 19-year-old man is brought into the trauma room by EMS after a head-
on cycling accident. The patient was not wearing a helmet. Upon presentation
his BP is 125/75 mm Hg, HR is 105 beats per minute, RR is 19 breaths per
minute, and oxygen saturation is 100% on mask. His eyes are closed, but open
to command. He can move his arms and legs on command. When you ask him
questions, he is disoriented but able to converse. What is this patient’s GCS
score?
a. 11
b. 12
c. 13
d. 14
e. 15
132 Emergency Medicine