A male patient with a closed head injury opens his eyes in response to pain, makes incomprehensible sounds, and responds to pain with flexion of his arms. His Glasgow Coma Scale score is ___, and the MOST appropriate treatment for him involves:

Question

A) 6; intubation, hyperventilation at a rate of 20 breaths/min, two large-bore IV lines running wide open, keeping him warm, and maintaining his oxygen saturation at greater than 90%.
B) 7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 95%.
C) 8; ventilation assistance with a bag-mask device, a 2-L bolus of normal saline or lactated Ringer's solution, elevating his head 12 inches, and hyperventilating him if his heart rate falls below 60 beats/min.
D) 9; high-flow oxygen via nonrebreathing mask, IV fluids as needed to maintain a systolic blood pressure of at least 100 mm Hg, monitoring his oxygen saturation, and administering 1.5 mg/kg of lidocaine to decrease intracranial pressure.

Answer 1

Answer: B) 7; intubation, ventilations performed at a rate of 10 breaths/min, IV fluids as needed to maintain a systolic blood pressure of at least 90 mm Hg, and maintaining his oxygen saturation at greater than 95%.