A 2.8-kg 8-hour-old infant undergoes laparotomy for a ruptured omphalocele. Following primary closure of the abdominal wall, arterial blood gases are PaO2 40 mmHg (FiO2 0.6), PaCO2 55 mmHg, and pH 7.1. Blood pressure is 30/20 mmHg. After increasing the FiO2, the most appropriate action would be to
(A) obtain a radiograph of the chest immediately
(B) withdraw the endotracheal tube 1 cm
(C) assess the patient for coexisting congenital heart disease
(D) administer lactated Ringer's solution 15 ml/kg
A meconium-stained, full-term infant has an initial Apgar score of 2. The oropharynx is suctioned and the infant is placed on a heated table. Which of the following is the most appropriate next step in management of the airway?
(A) If the oropharynx is clear, observation for respiratory effort
(B) Placement of an oxygen mask and application of positive pressure to clear the airway
(C) Nasotracheal suctioning
(D) Tracheal suctioning using the endotracheal tube
After termination of cardiopulmonary bypass, a patient who is chronically digitalized receives digoxin 0.5 mg in error. An ECG shows sinus bradycardia with intermittent sinus arrest; blood pressure is 90/60 mmHg. Which of the following drugs is contraiindicated in this patient?
During transurethral resection of the prostate under spinal anesthesia with a sensory level to T10, a patient has sudden onset of sharp upper abdominal pain and nausea. Arterial blood pressure increases from 120/80 to 150/90 mmHg; the patient becomes diaphoretic. Which of the following is the most likely diagnosis?
An unconscious adult patient is being ventilated through an esophageal obturator airway (EOA) in the emergency department. In the absence of cervical spine injury, which of the following is appropriate?
(A) Use of the EOA for airway management until the patient regains consciousness
(B) Removal of the EOA before insertion of an endotracheal tube
(C) Placement of an endotracheal tube before removal of the EOA
(D) Removal of the EOA under fiberoptic endoscopic visualization