Blunt trauma patient intubated in field, has decreased breath sounds on left, hemodynamically stable, sat 96% Next move: A) advance ET tube B) needle thoracostomy left chest C) left chest tube D) Chest x-ray E) pericardiocentesis
Blunt trauma patient intubated in field, has decreased breath sounds on left, hemodynamically stable, sat 96% Next move: A) advance ET tube B) needle thoracostomy left chest C) left chest tube D) Chest x-ray E) pericardiocentesis
Causes of cardiogenic shock in the trauma setting include all except: A) tension pneumothorax B) cardiac tamponade C) cardiac contusion D) Myocardial infarction E) spinal cord injury at C6
Causes of cardiogenic shock in the trauma setting include all except: A) tension pneumothorax B) cardiac tamponade C) cardiac contusion D) Myocardial infarction E) spinal cord injury at C6
44 year-old female, head-on collision, crushed steering wheel, hypotensive, tachycardic, bilateral breath sounds, no pericardial effusion on fast, +JVD. Cause of shock? A)Blunt cardiac injury B)Blunt aortic injury C)Tension pneumothorax D)Cardiac tamponade E)Flail chest
44 year-old female, head-on collision, crushed steering wheel, hypotensive, tachycardic, bilateral breath sounds, no pericardial effusion on fast, +JVD. Cause of shock? A)Blunt cardiac injury B)Blunt aortic injury C)Tension pneumothorax D)Cardiac tamponade E)Flail chest
Which vital signs in an adult are not consistent with major hemorrhage? A) BP 130/100, HR 149 B) BP 90/50, HR 80 C) BP 90/50, HR 120 D) BP 130/100, HR 110 E) all are possible in setting of major hemorrhage
Which vital signs in an adult are not consistent with major hemorrhage? A) BP 130/100, HR 149 B) BP 90/50, HR 80 C) BP 90/50, HR 120 D) BP 130/100, HR 110 E) all are possible in setting of major hemorrhage
Hypothermia following acute hemorrhage contributes to coagulopathy by way of A) onset of DIC B) platelet dysfunction C) factor V dysfunction D) leukocyte adherence dysfunction E) all of the above
Hypothermia following acute hemorrhage contributes to coagulopathy by way of A) onset of DIC B) platelet dysfunction C) factor V dysfunction D) leukocyte adherence dysfunction E) all of the above
Following massive transfusion with control of bleeding, unexplained hypotension may be a result of deficiency of which of the following? A) calcium B) sodium C) potassium D) citrate E) platelets
Following massive transfusion with control of bleeding, unexplained hypotension may be a result of deficiency of which of the following? A) calcium B) sodium C) potassium D) citrate E) platelets
Which of the following lab results is consistent with very recent blood loss? A) base excess +2 mmol/L B) sodium 135 C) hematocrit 9% D) hemoglobin 12 g/dL E) lactate 1.0 mmol/L
Which of the following lab results is consistent with very recent blood loss? A) base excess +2 mmol/L B) sodium 135 C) hematocrit 9% D) hemoglobin 12 g/dL E) lactate 1.0 mmol/L
Following head-on collision, hypotension, JVD and absent breath sounds on right – most consistent with A) cardiac tamponade B) massive hemothorax C) tension pneumothorax D) blunt cardiac injury E) blunt aortic injury
Following head-on collision, hypotension, JVD and absent breath sounds on right – most consistent with A) cardiac tamponade B) massive hemothorax C) tension pneumothorax D) blunt cardiac injury E) blunt aortic injury
ED thoracotomy is indicated for which patient? A) stab to left chest, no signs of life at scene, prehospital CPR x 15 min B) blunt trauma, initial signs of life at scene, prehospital CPR x 20 min, asystole on monitor C) stab to left chest, initial signs of life at scene, CPR x 5 min D) GSW at umbilicus, initial signs of life at scene, CPR x 10 min
ED thoracotomy is indicated for which patient? A) stab to left chest, no signs of life at scene, prehospital CPR x 15 min B) blunt trauma, initial signs of life at scene, prehospital CPR x 20 min, asystole on monitor C) stab to left chest, initial signs of life at scene, CPR x 5 min D) GSW at umbilicus, initial signs of life at scene, CPR x 10 min
A chest tube is placed for hemothorax following GSW to right chest. F/U CXR shows large retained hemothorax. Next step in management: A)Place 2 nd chest tube B)CT scan of chest C)Bronchoscopy D)TPA through chest tube E)OR for thoracotomy
A chest tube is placed for hemothorax following GSW to right chest. F/U CXR shows large retained hemothorax. Next step in management: A)Place 2 nd chest tube B)CT scan of chest C)Bronchoscopy D)TPA through chest tube E)OR for thoracotomy
Hemodynamically stable patient with stab wound just lateral to umbilicus. Next step in management: A) laparotomy B) local wound exploration C) CT scan D) laparoscopy E) DPL
Hemodynamically stable patient with stab wound just lateral to umbilicus. Next step in management: A) laparotomy B) local wound exploration C) CT scan D) laparoscopy E) DPL
Stable patient with stab wound to lower left back, no neurologic deficit, no hematuria. Next step in management A) CT scan abdomen/pelvis B) local wound exploration C) laparoscopy D) MRI spine E) laparotomy
Stable patient with stab wound to lower left back, no neurologic deficit, no hematuria. Next step in management A) CT scan abdomen/pelvis B) local wound exploration C) laparoscopy D) MRI spine E) laparotomy
GSW to left leg, mid thigh. Foot pulses on left not palpable but dopplerable. Palbable on right foot. No bony injury on xray. Next step… A) OR for exploration of artery B) CTA extremity C) angiogram D) Admit for serial vascular exams E) OR for on-table arteriogram
GSW to left leg, mid thigh. Foot pulses on left not palpable but dopplerable. Palbable on right foot. No bony injury on xray. Next step… A) OR for exploration of artery B) CTA extremity C) angiogram D) Admit for serial vascular exams E) OR for on-table arteriogram
33 year-old female, MVC, hypotensive, abdomen distended FAST -, CXR -, pelvic xray -. Next step… A) CT chest/abdomen/pelvis B) diagnostic laparoscopy C) exploratory laparotomy D) MRI spine E) DPA
33 year-old female, MVC, hypotensive, abdomen distended FAST -, CXR -, pelvic xray -. Next step… A) CT chest/abdomen/pelvis B) diagnostic laparoscopy C) exploratory laparotomy D) MRI spine E) DPA
45 year-old male, fall from ladder, hemodynamically stable, urine clear, cxr and pelvic xray neg, FAST shows fluid around liver and spleen. Next step… A) CT chest/abdomen/pelvis B) laparotomy C) DPA D)DPL E) laparoscopy
45 year-old male, fall from ladder, hemodynamically stable, urine clear, cxr and pelvic xray neg, FAST shows fluid around liver and spleen. Next step… A) CT chest/abdomen/pelvis B) laparotomy C) DPA D)DPL E) laparoscopy
28 year-old male, blunt pelvic fracture, blood at urethral meatus. Which of the following is indicated? A) carefully placed Foley catheter B) Retrograde urethrogram C) CT cystogram D) Suprapubic cystostomy E) scrotal ultrasound
28 year-old male, blunt pelvic fracture, blood at urethral meatus. Which of the following is indicated? A) carefully placed Foley catheter B) Retrograde urethrogram C) CT cystogram D) Suprapubic cystostomy E) scrotal ultrasound