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Skyscape - USMLE® Question of the Week


An unconscious 42-year-old man is brought to the emergency department by ambulance after sustaining a gunshot wound to the chest during an attempted robbery at a convenience store. He is bleeding profusely. The patient is minimally responsive to pain and is unable to provide any history. The ambulance record indicates that his initial blood pressure was 120/70 mm Hg, pulse was 95/min, and respirations were 16/min. The patient's current blood pressure is 70/40 mm Hg, pulse is 130/min, and respirations are 28/min. He has an open gunshot wound in the chest and an exit wound in the back. Intravenous fluids and vasopressors are started, and a blood transfusion is ordered. The patient's fiancé arrives and states that he should not receive a blood transfusion because he is a devout Jehovah's Witness. No evidence is found in the medical chart of advance directives or a living will documenting the patient's wishes, and examination of his belongings show no blood refusal card. Which of the following is the most appropriate next step in management of this patient?

A Administer high-dose erythropoietin and intravenous iron to stabilize blood loss
B Continue intravenous fluids and consult the hospital ethics committee
C Obtain a court order for approval to administer the blood transfusion
D Proceed with the blood transfusion
E Withhold the blood transfusion because of the patient s religious beliefs

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iOS & Android Apps

980+ total questions*
1000+ total questions*
450 Questions, Ans and Rationales
First Aid for the USMLE Step 1
Includes Netters Anatomy Atlas
Anatomy Flash Cards
* In app purchase required


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