Your patient is a 42-year-old male who is supine on the floor, responsive only to pain. His wife states that he has been extremely depressed recently and talked about suicide yesterday. The patient's skin is hot and dry, pupils are dilated and reactive to light bilaterally, and there is vomit around his mouth. HR = 138 and regular, BP = 82/52, RR = 16 and shallow. Temperature is 105.5°F. The

patient has a history of hypothyroidism, for which he takes Synthroid. Your partner suctions the airway and initiates BVM ventilations with 100 percent oxygen and an oropharyngeal airway. In addition to monitoring the cardiac rhythm and starting an IV of normal saline, you should:

A) perform synchronized cardioversion and intubate if the rhythm does not convert.
B) intubate the trachea and request orders for propranolol, IV.
C) intubate the trachea and request orders for diltiazem.
D) administer 25 g of 50 percent dextrose and intubate if the level of responsiveness does not improve.


B

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