Trauma

Pericardial Injury

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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

Sucking chest wound

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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
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
🆓 This is a free MCQ — click below to view the answer.
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Trauma

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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

High speed injury

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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

Similar Questions -

Aortic rupture

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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

Answer 

a) Distal to origin of subclavian 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.

Specific clinical findings are 

  1. Asymmetry of BP in upper limbs or upper and lower limbs
  2. Widened pulse pressure
  3. Chest wall contusions

Bailey page 355

http://www.msdmanuals.com/professional/injuries-poisoning/thoracic-trauma/aortic-disruption-traumatic