CAISS Thorax Injuries 2 — Questions and Answers
Question 1: A patient presents with paradoxical chest wall movement following blunt trauma. This finding is most consistent with:
- Simple pneumothorax
- Flail chest (Correct answer)
- Pulmonary contusion
- Hemothorax
Correct answer: Flail chest
Flail chest occurs when three or more consecutive ribs are fractured in two or more places, causing a free-floating segment that moves paradoxically with respiration.
Question 2: In the AIS, a tension pneumothorax is typically coded at which severity level?
- AIS 2
- AIS 3
- AIS 4 (Correct answer)
- AIS 5
Correct answer: AIS 4
Tension pneumothorax is coded as AIS 4 (severe) because it is life-threatening and causes significant hemodynamic compromise.
Question 3: Which thoracic injury is characterized by AIS code 450210.2?
- Rib fracture, 1 rib (Correct answer)
- Rib fracture, bilateral
- Sternum fracture
- Clavicle fracture
Correct answer: Rib fracture, 1 rib
AIS code 450210.2 corresponds to a single rib fracture, which is classified as AIS 2 (moderate severity).
Question 4: A patient sustains blunt thoracic trauma and develops hypoxia 24 hours later with bilateral infiltrates on chest X-ray but no cardiac failure. The most likely diagnosis is:
- Massive hemothorax
- Traumatic aortic injury
- Pulmonary contusion with ARDS (Correct answer)
- Pericardial tamponade
Correct answer: Pulmonary contusion with ARDS
Pulmonary contusion can progress to ARDS within 24–48 hours, presenting with bilateral infiltrates and hypoxia in the absence of cardiac failure.
Question 5: The AIS body region code for thoracic injuries is:
- 3
- 4 (Correct answer)
- 5
- 6
Correct answer: 4
AIS body region 4 corresponds to the thorax, which includes the chest wall, lungs, heart, and major thoracic vessels.
Question 6: Which of the following best defines a 'simple' pneumothorax in AIS coding?
- Pneumothorax with hemothorax
- Pneumothorax without tension or lung collapse >50% (Correct answer)
- Pneumothorax requiring surgical repair
- Open pneumothorax with sucking wound
Correct answer: Pneumothorax without tension or lung collapse >50%
A simple pneumothorax is defined by partial lung collapse without tension and without significant hemothorax, typically coded as AIS 3.
Question 7: Bilateral pulmonary contusions are assigned a higher AIS score than unilateral contusions primarily because:
- They are more painful
- They compromise more total lung volume and oxygenation (Correct answer)
- They always require surgical intervention
- Bilateral injuries default to AIS 5 by definition
Correct answer: They compromise more total lung volume and oxygenation
Bilateral pulmonary contusions compromise a greater proportion of total lung parenchyma, leading to more severe hypoxia and a higher AIS severity code.
CAISS Thorax Injuries 2
A patient presents with paradoxical chest wall movement following blunt trauma.
This finding is most consistent with: