Question

A man was stabbed to the left side of the chest. His skin is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are 22 breaths/min, and his pulse is 120 beats/min and weak. His breath sounds are equal bilaterally and his jugular veins are distended. What should you do?

A) Apply a pressure dressing to the wound
B) Administer epinephrine
C) Assist ventilations with a bag-valve mask
D) Monitor for changes in mental status

Answer 1

The man may be experiencing cardiac tamponade and should receive immediate medical attention. Apply a pressure dressing to the chest wound, monitor mental status, and prioritize rapid medical transport to a facility capable of handling traumatic injuries.

Step-by-step explanation:

The signs and symptoms that the man exhibits suggest that he may be experiencing a condition known as cardiac tamponade, which is a type of pericardial effusion where fluid accumulates in the pericardial sac, causing pressure on the heart and leading to jugular vein distension and hypotension. The fact that his jugular veins are distended, along with the other vital signs, points to this condition. The immediate steps would include:

• Apply a pressure dressing to the wound to help control the bleeding.
• Monitor for changes in mental status due to the potential for decreased cerebral perfusion.
• Prepare for immediate transport to a medical facility for further evaluation and management.

Giving epinephrine without advanced cardiac life support training or in the absence of anaphylaxis is not advised. Assisting ventilations with a bag-valve mask is not necessary given that the respirations are adequate at 22 breaths/min. The most crucial action is to stop the bleeding and expedite transport to an emergency room where definitive care, including possible surgery, can be provided.