You are collaborating with the trauma team to admit and stabilize Johny Snowden, 17-year-old male following a snow mobile accident. Mr. Snowden was driving his snow mobile on a frozen lake when he hit a patch of thin ice and went through the ice. According to Emergency Medical Service after the vehicle went through the ice. Mr. Snowden did not resurface. The patient's father witnessed the event and went in after his son and was able to rescue him. He immediately began CPR. Mr. Snowden was intubated en route to the Trauma Center by the paramedics and presents now for stabilization. You collect the following assessment data on Mr. Tean.

Based on the assessment findings, what priority actions will you take to help stabilize Mr. Snowden at this time? (Select all that apply, some, one or all)

Rationale:

A. Mr. Snowden was submerged in icy water, which puts him at high risk for hypothermia. Hypothermia can worsen coagulopathy, impair cardiac function, and affect drug metabolism. Maintaining normothermia through warming blankets, warmed IV fluids, and environmental temperature control is essential for stabilization and to prevent secondary complications.

B. There is no indication of a urinary tract infection in the current assessment. Administering antibiotics for a UTI would be unnecessary and not a priority in the acute stabilization phase. Priority interventions should focus on immediate life-threatening issues and injuries sustained from the accident.

C. With a complete T10 spinal cord injury, frequent neurologic assessments are vital to monitor for changes in motor function, sensation, and reflexes above the level of injury. Hourly checks help detect complications such as autonomic dysreflexia, spinal shock, or evolving cord edema. Monitoring the Glasgow Coma Scale (even with intubation), voluntary movements in extremities, and sensory response is part of these assessments.

D. Spinal precautions are critical due to the complete T10 injury. The log-roll technique maintains spinal alignment and prevents further cord damage while turning, repositioning, or performing hygiene care. All staff must coordinate movements to prevent rotation or flexion of the spine.

E. The large abrasion/laceration on the scalp could lead to significant bleeding, infection, or indicate underlying skull fracture. Assessment includes checking for active bleeding, signs of hematoma or swelling, neuro changes, and proper wound care. This is important to prevent secondary complications and infection.

F. Mr. Snowden’s vital signs (heart rate 72 bpm, respiratory rate 16, oxygen saturation 99%) are currently stable. There is no evidence of hypovolemia or shock, so IV fluid bolus is not immediately indicated. Fluids may be considered later if hypotension develops or in response to lab values.

G. Collecting accurate information about the accident helps determine timing of submersion, duration of CPR, previous medical conditions, medications, allergies, and baseline neurologic function. This informs ongoing care decisions, prognostication, and potential complications such as hypoxic brain injury or organ damage.

H. Mr. Snowden is intubated and fully dependent on mechanical ventilation. Continuous monitoring of airway patency, ventilator settings, oxygenation, and tidal volumes is a life-saving priority. Ensuring suctioning is performed as needed and preventing ventilator-associated complications (e.g., pneumonia) are also part of stabilization.