You are called to a local gym for a patient with nausea. Your patient, a 29-year-old man, tells you that he thinks he has a "stomach bug." He is conscious and alert, denies chest pain or shortness of breath, and tells you that he has been nauseated for the last 4 hours but has not vomited. His blood pressure is 124/66 mm Hg, pulse is 46 beats/min and strong, respirations are 20 breaths/min and regular, and room air oxygen saturation is 99%. The cardiac monitor reveals a sinus bradycardia. You should:
A) give 100% oxygen, start two large-bore IV lines, administer 20 mL/kg normal saline boluses, and transport.
B) administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.
C) advise him that he can probably drive himself to the emergency department or schedule an appointment with his physician.
D) apply high-flow oxygen via nonrebreathing mask, start an IV line, administer 0.5 mg of atropine, and transport to the closest facility.
Answer: B) administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.
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You are caring for a patient who refuses treatment and transport. However, you are unsure whether he is capable of a rational decision. You should:
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