A 20-year-old man involved in a motor vehicle accident is brought to the operating room for irrigation and debridement of open fractures of the femur and humerus. Cyanosis, decreased breath sounds on the left, increased peak airway pressure, and hypotension are noted after intubation of the trachea. The most likely cause is
The induction dose of thiopental should be decreased in each of the following situations EXCEPT
During emergency laparotomy, a patient who has been taking a monoamine oxidase inhibitor for six months develops hypotension despite adequate fluid therapy. The most appropriate management is administration of
The newborn infant of an 18-year-old heroin addict has an initial Apgar score of 1. After intubation of the trachea and ventilation with pure oxygen, the Apgar score is 3 at five minutes. Appropriate management at this time would include administration of each of the following EXCEPT
Which of the following is the most likely cause of rapid oxygen desaturation during laryngoscopy In a pregnant woman?
Immediately after sustaining severe head injury, a 20-year-old man has a blood pressure of 150/90 mmHg and an intracranial pressure of 35 mmHg. After one hour of thiopental infusion, blood pressure is 105/60 mmHg, intracranial pres sure is 20 mmHg, central venous pressure is 5 mmHg, and temperature is 36°C. The EEG shows slow-wave activity. The most appropriate next step is administration of
A 70-kg man with ischemic heart disease is undergoing abdominal aortic aneurysm resection. At the time of infrarenal cross-clamping, 0.2-mV ST-segment depression appears on lead V5 of the ECG. Hemodynamic changes occurring at the same time are shown below. Systemic blood pressure 90/50 --> 150/90; Heart rate 80 --> 95; PAp 20/10 --> 45/24; Mean pulmonary artery occlusion pressure (mmHg) 10 --> 23; Cardiac output (L/min) 4.5 --> 3.2. Ischemia would be decreased by restoring the pre-clamp level of each of the following EXCEPT
A conscious patient has an acute subdural hematoma that will require surgical evacuation. Which of the following interventions to be carried out in the emergency department is most likely to decrease intracranial pressure?
A 29-year-old man who has been nasotracheally intubated for two weeks following a motor vehicle accident has a fever (39C) and a constant headache. Leukocyte count is 18,000/mm3. The most likely cause is
Which of the following cardiovascular abnormalities is LEAST likely to be present in a patient with end-stage alcoholic cirrhosis?