You Are Called to a Local Physician's Office Where You

Multiple Choice

You are called to a local physician's office where you find a 52-year-old male patient with a history of chronic renal failure. He is conscious but disoriented. The physician reports that the patient's wife brought him in because he has had a "chest cold," missed dialysis yesterday, and is now "acting strangely." Physical examination reveals cool, diaphoretic skin; edema to dependent areas, and lung sounds with rhonchi in the right upper lobe. HR = 118, BP = 142/100, RR = 20 and deep, SaO₂ = 97%, blood glucose = 79 mg/dL. Bloodwork performed by the physician in his office indicates a pH of 7.2. In addition to 15 liters per minute of oxygen by nonrebreathing mask and an IV of normal saline at a keep-open rate, which of the following is most appropriate for this patient in the prehospital setting?

A) IV sodium bicarbonate, 1 mEq/kg
B) IV magnesium sulfate, 10 gm
C) IV dextrose, 25 gm
D) IV furosemide, 120 mg