ATLS Thoracic Trauma 2

Question 1

A patient with blunt chest trauma has paradoxical chest wall movement. What is the primary cause of hypoxia?

Accepted Answer

Underlying pulmonary contusion

Answer

Paradoxical movement alone

Answer

Rib fracture pain

Answer

Diaphragmatic paralysis

Question 2

A chest tube initially drains 1,800 mL of blood. According to ATLS, next step?

Accepted Answer

Prepare for emergent thoracotomy

Answer

Continue observation

Answer

Clamp tube and reassess

Answer

Autotransfuse and observe

Question 3

An open pneumothorax (sucking chest wound) is initially managed with which intervention?

Accepted Answer

Three-sided occlusive dressing

Answer

Chest tube through the wound

Answer

Four-sided occlusive dressing

Answer

Positive pressure ventilation alone

Question 4

Widened mediastinum on CXR after high-speed deceleration suggests which injury?

Accepted Answer

Traumatic aortic injury

Answer

Esophageal rupture

Answer

Tracheobronchial disruption

Answer

Myocardial contusion

Question 5

A chest tube is in place but there is continuous air leak with the lung not re-expanding. Diagnosis?

Accepted Answer

Tracheobronchial disruption

Answer

Chest tube malposition

Answer

Simple converting to tension

Answer

Esophageal perforation

Question 6

What is the preferred initial study for suspected blunt cardiac injury in a stable patient?

Accepted Answer

12-lead ECG

Answer

Cardiac catheterization

Answer

Cardiac MRI

Answer

Transesophageal echo