SAQ 392 – Trauma – blunt abdominal trauma FAST and ROTEM

A 70 kg 23-year-old woman is brought to a tertiary emergency department one hour after a high-speed motor vehicle crash. She has abdominal pain. Initial observations and pre-FAST treatment are shown below.

FAST images and a later ROTEM result are shown below.

Observation	Result
GCS	15
Heart rate	120/min
Blood pressure	100/60 mmHg
Oxygen saturation	96% on room air
Respiratory rate	22/min
Prehospital/initial therapy	Fentanyl 100 microg IV, ondansetron 8 mg IV, and 500 mL normal saline IV without vital-sign change

Label structures 1-13 on the FAST images.

(Marked out of 13.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Label</th> <th>Structure</th> </tr> </thead> <tbody> <tr> <td>1</td> <td></td> </tr> <tr> <td>2</td> <td></td> </tr> <tr> <td>3</td> <td></td> </tr> <tr> <td>4</td> <td></td> </tr> <tr> <td>5</td> <td></td> </tr> <tr> <td>6</td> <td></td> </tr> <tr> <td>7</td> <td></td> </tr> <tr> <td>8</td> <td></td> </tr> <tr> <td>9</td> <td></td> </tr> <tr> <td>10</td> <td></td> </tr> <tr> <td>11</td> <td></td> </tr> <tr> <td>12</td> <td></td> </tr> <tr> <td>13</td> <td></td> </tr> </tbody> </table> <p>

/ 13

State the key finding on these images.

(Marked out of 1.0)

/ 1

After two units of warmed O-negative PRBC and activation of a massive transfusion protocol, her heart rate is 100/min and blood pressure is 100/80 mmHg. Give two (2) indications for CT angiography in this patient.

(Marked out of 2.0)

/ 2

Later her systolic blood pressure falls to 85 mmHg and she appears pale. Based on the ROTEM, state the factor replacement, including dose and route.

(Marked out of 2.0)

/ 2

Total Score: 0 / 18

Percentage: 0%