Q) A 25-year-old male presents after a stab wound to the left 5th intercostal space at the midclavicular line.
He is hypotensive, tachycardic, and confused. eFAST reveals pericardial fluid. What is the next best step in management?
A. Pericardiocentesis
B. Emergency thoracotomy
C. CT angiography of the chest
D. Chest tube insertion
Q) A 30-year-old male presents to the emergency department after a stab wound to the right chest. On examination, there is a 4 cm open wound in the 5th intercostal space anteriorly, with a sucking sound during inspiration, decreased breath sounds on the right, and respiratory distress. What is the next best step in management? # Theme neet ss mocktest 1 A. Immediately close the wound with an airtight dressing Q) Not a frontline treatment of flail chest ( Trauma Questions - 9) a) Mechanical ventilation to internally splint the chest b) Physiotherapy c ) oxygen d) Opiate
Q) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious, BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not raised and heart sounds are normal. Respiratory rate is 22/min What does he have a) Left heart failure b) Fat Embolism c) Pneumothorax d) Fluid loss
Q) DENVER CRITERIA is used in d) Penetrating abdominal injury Q) A young 18 years old unrestrained car driver has an head on collision with a truck and becomes unconscious. He is intubated on the site of accident and resuscitated with IV fluids. He is brought to the emergency in a state of shock,( BP 90/60 and pulse 120/min) but opens eyes on commands. On examination he does not have pallor but neck veins are distended. There are no signs suggestive of head or spine injury. Xray chest reveals normal cardiac chambers, no free gas and mild pleural effusion on left with no evidence of fracture ribs. What will be the next step of management a) Resuscitation and simultaneous CT thorax b) Resuscitation and simultaneous Echo cardiography c) Exploratory laparotomy d) Chest tube drainage left side
Answer a) Distal to origin of subclavian artery Specific clinical findings are Bailey page 355 http://www.msdmanuals.com/professional/injuries-poisoning/thoracic-trauma/aortic-disruption-traumatic Q) In penetrating neck trauma, to help in the management, neck has been divided into zones. Great vessels of thoracic inlet are seen in (#Gen Surgery Trauma) a) Zone 1 b) Zone II c) Zone III d) None
Sucking chest wound
B. Insert a chest tube on the same side and then close the wound
C. Intubate and initiate positive pressure ventilation
D. Apply a three-sided occlusive dressing to the wound
Flail Chest Management
Trauma
Denver Criteria
a. Blunt cerebrovascular trauma
b. Chest trauma
c. Blunt trauma abdomen
High speed injury
Aortic rupture
Q) Most common site for traumatic aortic rupture is
a) Distal to the origin of left subclavian artery
b) Point of entry of aorta above the diaphragm
c) Root of aorta
d) Point distal to Left carotid artery
Traumatic aortic rupture leads to sudden death after high impact automobile accident or fall from height. Aorta is relatively fixed distal to ligament arteriosum just distal to the origin of subclavian artery and this is the most common site of traumatic rupture especially partial rupture in which adventitia is intact.
Penetrating Neck trauma
