You are assessing an unresponsive 66-year-old man with a history of two prior strokes. According to the patient's wife, he complained of a severe headache and then passed out. His respiratory effort is poor, blood pressure is elevated markedly, and pulse is slow and bounding. The glucometer reads "error." You should:
A) give high-flow oxygen, apply the cardiac monitor, start an IV line with normal saline, and administer 0.5 mg of atropine to treat his bradycardia.
B) hyperventilate with a bag-mask at 30 breaths/min, begin transcutaneous pacing, establish vascular access, and administer 25 g of 50% dextrose.
C) intubate after 30 seconds of preoxygenation, ventilate at a rate of 8 breaths/min, start an IV with normal saline, administer 50 g of 50% dextrose, and reassess.
D) assist ventilations, apply the cardiac monitor, start an IV line with normal saline, administer 12.5 g of 50% dextrose, and reassess his level of consciousness.
Answer: D) assist ventilations, apply the cardiac monitor, start an IV line with normal saline, administer 12.5 g of 50% dextrose, and reassess his level of consciousness.
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