SAQ 487 – Trauma – high-speed MVC in late pregnancy

A 26-year-old woman who is 32 weeks pregnant is brought to your tertiary hospital after a high-speed motor vehicle crash. She has seatbelt marks across her chest and abdomen. Her initial observations are shown below.

Observation	Result
GCS	15 (E4 V5 M6)
Heart rate	100/min
Blood pressure	100/60 mmHg
Respiratory rate	20/min
SpO2	98% on 6 L oxygen via Hudson mask

State five (5) management priorities.

(Marked out of 5.0)

/ 5

List three (3) imaging modalities you would consider and state three (3) pros and three (3) cons for each.

(Marked out of 21.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Imaging modality</th> <th>Pros</th> <th>Cons</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> <td></td> </tr> <tr> <td>2.</td> <td></td> <td></td> </tr> <tr> <td>3.</td> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 21

Name five (5) physiological changes of pregnancy and state how each affects trauma assessment.

(Marked out of 10.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Physiological change</th> <th>Assessment implication</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> </tbody> </table> <p>

/ 10

She develops vaginal bleeding and reports no fetal movements since the crash. What is your most important differential diagnosis?

(Marked out of 1.0)

/ 1

List three (3) investigations relevant to this diagnosis and state their utility.

(Marked out of 6.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Investigation</th> <th>Utility</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> </tbody> </table> <p>

/ 6

Total Score: 0 / 43

Percentage: 0%