Question

A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should:

1) administer oxygen via a nonrebreathing mask, apply oral glucose in between his cheek and gum, and transport.
2) suspect that he has internal bleeding and is in shock, administer high-flow oxygen, and transport at once.
3) administer high-flow oxygen, perform a detailed secondary assessment at the scene, and transport promptly.
4) suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital.

Answer 1

The correct course of action for the unresponsive male patient with hemophilia and signs of bradycardia, hypertension, and hypoventilation is to suspect intracranial bleeding, assist his ventilations, and urgently transport him to a hospital for appropriate care.

Step-by-step explanation:

The scenario presents a 42-year-old male found unresponsive with a combination of symptoms including hypertension (high blood pressure), bradycardia (low heart rate), and hypoventilation (low respiratory rate), while also having a medical history of hemophilia, a blood disorder that impairs the body's ability to form blood clots. Considering these signs and symptoms, as well as the potential for a hemophiliac patient to experience internal or intracranial bleeding, option 4) suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital would be the most appropriate course of action.

The patient's blood glucose level is within the normal fasting range (75 mg/dL), which excludes immediate concern for hypoglycemia as a cause of his unresponsiveness. However, his low respiratory rate and irregular pattern indicate potential respiratory compromise, which warrants immediate intervention, such as ventilation assistance, to ensure adequate oxygenation.