SAQ 737 – Trauma – severe abdominal trauma with splenic injury and lethal triad

You work in a Level 1 Trauma Centre and receive pre-notification of a 23-year-old man in a high-speed single-vehicle crash into a pole.

He has abdominal injuries, was intubated at the scene, has one large-bore IV cannula, has received 250 mL normal saline, and has been placed in a hard collar and pelvic binder.

After initial expert management his haemodynamics improve enough for CT. Two consecutive abdominal CT slices are shown.

Observation	Value
Temperature	34 degrees C
HR	160 bpm
BP	75/50 mmHg
SpO2	99% on FiO2 0.6
GCS	3 (E1 M1 V1)

List the three (3) components of the lethal triad of trauma. For each component, list two (2) actions you would take to reduce morbidity and mortality.

(Marked out of 9.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Component</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Actions</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">1</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">2</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">3</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 9

State the three (3) most important findings on the abdominal CT.

(Marked out of 3.0)

/ 3

List three (3) indications for angioembolisation in this context.

(Marked out of 3.0)

/ 3

List four (4) laboratory targets you would use to guide massive transfusion.

(Marked out of 4.0)

/ 4

Total Score: 0 / 19

Percentage: 0%