A 49-year-old man was fishing in a stream of cold water when he became submerged after getting tangled in some hidden roots. The patient was pulled from the stream by friends after approximately 5 minutes of submersion. Your assessment reveals him to be responsive to painful stimuli and breathing 5 times per minute. His pulse is weak and rapid. Which of the following instructions should you give to the team of rescuers?
A) Do not wipe the water off him. It will keep his body cool and protect vital organs like his brain and heart.
B) Do not apply the AED if he goes into cardiac arrest. The water was very cold and the AED is contraindicated in hypothermia.
C) I need someone to perform abdominal thrusts to see if he took water into his stomach.
D) Let's move him into the warm ambulance as quickly as possible, and then cut off his clothes and cover him.
Question 2
Your patient is a 32-year-old male who has been successfully treated for depression with a selective serotonin reuptake inhibitor. The patient's wife is concerned, because over the past few days her husband has not slept and has been spending most of his time trading stocks online and making extravagant purchases. He has been talking about taking a trip to Spain to run with the bulls in Pamplona. She states that he is talking incessantly and seems wired. The patient had a similar episode about a month ago that came on suddenly but resolved when the patient crashed and slept for several days. Which of the following is most consistent with this situation?
A) Cocaine use
B) Schizoaffective disorder
C) Methamphetamine use
D) Bipolar disorder
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