MedMigrant

Question 123 · LEK · Multi-organ trauma

A 35-year-old motorcyclist was admitted to the ER after a traffic accident. He is unconscious. On physical examination: the abdomen is rigid, HR 140/min, BP 60/40 mmHg, GCS 3, on auscultation there is no respiratory sound over the left pleural cavity. On the FAST examination fluid is detected in the peritoneal cavity. Hb concentration is estimated at 6.5 g/dL on the arterial blood gas test. Indicate the correct sequence of necessary procedures:

  1. A. full-body CT scan-laparotomy - drainage of the left pleural cavity.
  2. B. chest X-ray - drainage of the left pleural cavity - laparotomy.
  3. C. drainage of the left pleural cavity - laparotomy - full-body CT scan after stabilization of patient’s general condition.
  4. D. admission to ICU - massive blood transfusion - laparotomy after stabilization of patient’s general condition.
  5. E. laparotomy - drainage of the left pleural cavity - full-body CT scan after stabilization of patient’s general condition.
Hint

In a patient in extremis, first treat the immediately reversible chest problem, then stop the bleeding, and image only once the patient is stable.

The answer, the explanation and a note on every option are available once you log in. The account is free: topic tests, a mock exam, mistake review and statistics.

Create a free account Log in

More questions on Emergency medicine, anesthesiology and intensive care