Trauma & Procedural Skills Flashcards
7 cards from real ABEM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Trauma & Procedural Skills flashcards as text
A patient has a shotgun wound to the right chest with sucking chest wound. After occlusive dressing placement the patient acutely deteriorates. What is the most likely cause?
Answer: Tension pneumothorax from occluded dressing
A fully occlusive dressing on an open pneumothorax can convert it to a tension pneumothorax if air cannot escape.
What is the correct placement site for an intraosseous (IO) needle in an adult trauma patient when IV access is unavailable?
Answer: Proximal tibia 2 cm below tibial tuberosity medially
The proximal tibia 2 cm below and medial to the tibial tuberosity is the preferred IO site in adults.
A trauma patient with a suspected diaphragmatic rupture is intubated. Which finding on chest X-ray is most specific?
Answer: Nasogastric tube coiled in left chest
A nasogastric tube visible in the left chest cavity is pathognomonic for left-sided diaphragmatic rupture with gastric herniation.
Which maneuver is used to confirm proper endotracheal tube placement in a trauma patient immediately after intubation?
Answer: Waveform capnography combined with clinical assessment
Continuous waveform capnography is the gold standard for confirming ETT placement, especially during trauma resuscitation.
In damage control resuscitation, what ratio of packed red blood cells to fresh frozen plasma to platelets is recommended?
Answer: 1:1:1
A 1:1:1 ratio of pRBC:FFP:platelets approximates whole blood and is the standard for damage control resuscitation.
A 25-year-old with a stab wound to the left chest develops JVD, hypotension, and muffled heart sounds. What procedure is indicated?
Answer: Needle pericardiocentesis or ED thoracotomy
Beck's triad (JVD, hypotension, muffled heart sounds) indicates cardiac tamponade requiring pericardiocentesis or ED thoracotomy.
During central venous line placement in a trauma patient, which complication is identified by worsening hypoxia, hypotension, and distended neck veins after line insertion?
Answer: Iatrogenic tension pneumothorax
Pneumothorax complicating subclavian or internal jugular CVC placement can tension if the patient is on positive pressure ventilation.