A hiker was bitten on the left lower leg by a rattlesnake. He is conscious and alert, but complains of nausea and generalized weakness. The affected area, which has two distinct puncture wounds, is swollen markedly. The patient's blood pressure is 114/66 mm Hg, pulse rate is 120 beats/min and regular, and respirations are 22 breaths/min and regular. The MOST appropriate treatment for this patient involves:
A) keeping him calm, administering high-flow oxygen, immobilizing the affected extremity and keeping it below heart level, and establishing vascular access.
B) applying venous tourniquets proximal and distal to the affected site, elevating the limb no more than 12 inches, applying a splint, and establishing vascular access.
C) administering oxygen, providing emotional support, establishing vascular access, administering a 250-mL saline bolus, and splinting the affected extremity.
D) placing him in a supine position, elevating the affected extremity and applying ice to reduce the swelling, establishing vascular access, and administering fentanyl for pain.
Answer: A) keeping him calm, administering high-flow oxygen, immobilizing the affected extremity and keeping it below heart level, and establishing vascular access.
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