SAQ 809 – Trauma – blunt chest trauma initial CXR and deterioration

You are the consultant in a tertiary trauma centre. Prehospital notification is received for a 50-year-old man arriving in 10 minutes after a high-speed motor vehicle collision into a tree.

List two (2) critical conditions you are concerned about, and for each provide a supporting finding visible on the CXR.

(Marked out of 4.0)

Observation	Value
HR	140
BP	90/64
GCS	15
Sats	90% on 15 L non-rebreather mask

</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;">Condition</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Supporting CXR finding</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> </tbody> </table> <p>

/ 4

Based on these findings, state your immediate emergency department management.

(Marked out of 1.0)

/ 1

He becomes agitated and pulls off his oxygen mask. List five (5) possible causes of altered conscious state in this context.

(Marked out of 5.0)

/ 5

After intubation his HR is 90, BP 100/52 and oxygen saturation 84% on FiO2 1.0. List five (5) causes of this deterioration.

(Marked out of 5.0)

/ 5

CT confirms isolated chest injuries. List three (3) indications for immediate emergent operative management.

(Marked out of 3.0)

/ 3

Total Score: 0 / 18

Percentage: 0%