You are on the scene of a motor-vehicle crash involving a van that carries patients to and from dialysis. The van has rolled over and, during the crash, the patient in the rear of the van sustained a nearly severed right arm. The patient is conscious, pale, and diaphoretic. He has an A/V shunt in the unaffected arm. Bleeding has been controlled to the best it can be and immobilization is
complete. What is your most prudent action regarding IV access?
A) Cannulate the shunt; the patient is obviously decompensating due to blood loss.
B) Look for other sites for venipuncture.
C) Now that the bleeding is controlled, there should be no need to access the shunt and risk its contamination.
D) Call for a supervisor to make the decision to cannulate the shunt.
B
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