<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 35-year-old soldier is rescued from a helicopter crash in the Arctic Circle and brought back to a treatment facility at a nearby military base. On arrival, the patients wet clothes are removed. He appears pale and is not shivering. He is unresponsive to verbal and painful stimuli. His temperature is 27.4C 81.3F, pulse is 30min and irregular, respirations are 7min, and blood pressure is 8352 mm Hg. Examination shows fixed, dilated pupils and diffuse rigidity. The fingers and toes are white in color and hard to the touch. An ECG shows atrial fibrillation. In addition to emergent intubation, which of the following is the most appropriate next step in management?? A: Intravenous administration of tissue plasminogen activator, B: Intravenous administration of diltiazem, C: Application of heating pads to the extremities, D: Intravenous administration of warmed normal saline, E: Emergent electrical cardioversion,  <response>: This is a question about the management of severe hypothermia. The patient is described as having a core body temperature of 27.4C, bradycardia, hypotension, fixed dilated pupils, rigidity, and evidence of peripheral cold injury. These findings are consistent with profound hypothermia. The key steps in managing severe hypothermia are preventing further heat loss, passive rewarming, active core rewarming, and managing complications. Choice A, tissue plasminogen activator, is used for ischemic stroke and myocardial infarction, not hypothermia. Choice B, diltiazem, is a calcium channel blocker used to treat hypertension and certain arrhythmias; it is not indicated in this setting. Choices C and E, heating pads and electrical cardioversion, are not recommended initial steps. Choice D, intravenous warmed normal saline, is the most appropriate next step because it will help increase core temperature through internal rewarming.D: Intravenous administration of warmed normal saline 