SAQ 1013 – Trauma – fall with chest pain and chest x-ray

A 73-year-old man presents after a fall from standing height while playing tennis. He has right shoulder pain and pleuritic right-sided chest pain.

He has antithrombin III deficiency with previous DVTs and takes lifelong warfarin. Observations are RR 18/min, SpO2 98% on room air, HR 87/min and BP 145/85 mmHg. Examination shows mild diffuse right anterior chest wall tenderness and tense swelling over the right deltoid.

His CXR is shown.

List three CXR findings.

(Marked out of 3.0)

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What historical or examination findings justify CT imaging to identify traumatic thoracic injuries?

(Marked out of 4.0)

/ 4

While in ED he suddenly develops severe respiratory distress with RR 40/min, SpO2 80% on air, HR 110/min and BP 70/40 mmHg. What are your immediate management priorities?

(Marked out of 4.0)

/ 4

After stabilisation he is admitted to ICU, awake and spontaneously ventilating on 2 L oxygen. List three pharmacological pain strategies for this condition, with one advantage and one disadvantage of each.

(Marked out of 6.0)
</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;">Option</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Advantage</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Disadvantage</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></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;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></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;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

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Total Score: 0 / 17

Percentage: 0%