Law enforcement requests your assistance for a 40-year-old man whom they found in an alley. According to one police officer, the patient is "probably drunk." The outside temperature is 37°F with a light wind and drizzle. The patient, who is conscious but confused, is shivering and has slurred speech. His skin is cold and pale, his heart rate is 68 beats/min and regular, and his respirations are 24 breaths/min and regular. After moving the patient into the warmed ambulance, you should:

Question

A) assess his blood pressure, apply chemical heat packs to his neck, groin, and axillae, infuse 250 to 500 mL of warm normal saline, and administer one or two tubes of oral glucose.
B) remove his wet clothing, apply warm blankets, administer supplemental oxygen, assess his blood glucose level and blood pressure, and start an IV with warm normal saline.
C) apply warm layered blankets, administer 100 mg of thiamine IM, administer oxygen via nasal cannula, start an IV line with lactated Ringer's solution, and administer 25 grams of 50% dextrose.
D) remove his wet clothing, apply chemical heat packs directly to the groin, assess his blood glucose level and treat with dextrose if it is less than 80 mg/dL, and administer high-flow oxygen.

Answer 1

Answer: B) remove his wet clothing, apply warm blankets, administer supplemental oxygen, assess his blood glucose level and blood pressure, and start an IV with warm normal saline.