You are the consultant in a busy urban ED and receive an ambulance pre-notification about two patients from a domestic dispute with shotgun wounds, arriving in 10 minutes.
Patient 1 is a 46-year-old man with wounds to the left chest and abdomen, GCS 12 (E3 V4 M5), pulse 110/min and BP 80 mmHg systolic. Patient 2 is a 43-year-old woman with minor left forearm wounds and stable observations.
The male patient's chest X-ray is shown below.
Chest X-ray.
Outline four key issues in this scenario.
(Marked out of 4.0)
/ 4
The male patient remains shocked despite 2 L normal saline pre-hospital. His GCS falls to 8, his right chest is hyper-resonant with bilaterally reduced breath sounds, and he has an acute abdomen. List four immediate management priorities.
(Marked out of 4.0)
/ 4
List five positive findings on the male patient's chest X-ray.
(Marked out of 5.0)
/ 5
After the male patient is transferred to theatre, police advise that the suspected perpetrator may arrive and may be armed. Outline four key issues in your immediate response.
(Marked out of 4.0)
/ 4
Total Score: 0 / 17
Percentage: 0%
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