A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation
his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per
minute and his respiratory rate is 28 breaths per minute. A tube thoracostomy is
performed for decreased left chest breath sounds with the return of a small amount
of blood and no air leak. After chest tube insertion, the most appropriate next step is:
Select one:
a. Reexamine the chest
b. Perform an aortogram
c. Obtain a CT scan of the chest
d. Obtain arterial blood gas analyses
e. perform transesophageal echocardiography
Correct answers - a
Reexamine the chest
correct answerers
A construction worker falls two stories from a building and sustains bilateral
calcaneal fractures. In the emergency department, he is alert, vital signs are normal,
and he is complaining of severe pain in both heels and his lower back. Lower
extremity pulses are strong and there is no other deformity. The suspected diagnosis
is most likely to be confirmed by:
Select one:
a. Angiography
b. compartment pressures
c. Retrograde urethrogram
d. Doppler ultrasound studies
e. Complete spine x-ray series
Correct answers – e
Complete spine x-ray series
correct answerer –
Which of the following is true regarding the initial resuscitation of a trauma patient?
Select one:
a. A patient that presents with a torso gunshot wound and is hypotensive should
receive crystalloid fluid resuscitation until the blood pressure is normal.
b. Evidence of improved perfusion after fluid resuscitation could include
improvement in Glasgow coma scale score on reevaluation
c. Massive transfusion is defined as transfusion of more than >10 of packed red
blood cells and plasma in 24 hours
d. When tranexamic acid is administered by pre-hospital providers a second
dose is required within 24 hours
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