A 45-year-old man presents with severe cramps in his legs, nausea, and lightheadedness after running laps at the track. The temperature outside is 95°F and the relative humidity is 80%. The patient is conscious and alert and is sweating profusely. His blood pressure is 100/60 mm Hg, pulse is 120 beats/min and weak, and respirations are 24 breaths/min and regular. The MOST appropriate treatment for this patient involves:
A) giving him a salt-containing solution to drink, applying chemical ice packs to the back of his neck, and discouraging further activity for the day.
B) administering high-flow oxygen, gently massaging his lower extremities to enhance circulation, administering 1 µg/kg of fentanyl IM, and transporting.
C) offering him oxygen, starting an IV with normal saline, giving a 250- to 500-mL fluid bolus, and recommending transport to the hospital for evaluation.
D) having him chew salt tablets, starting an IV with D5W at a keep-vein-open rate, administering 12.5 mg of promethazine IV, and transporting to the hospital.
Answer: C) offering him oxygen, starting an IV with normal saline, giving a 250- to 500-mL fluid bolus, and recommending transport to the hospital for evaluation.
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