TCRN Practice Questions: Trunk Part 1 (Thoracic & Abdominal Trauma)2022/2023

When should impaled objects be removed? Preferably in the OR, under controlled circumstances. True or false: Bullet wounds follow a predictable pattern of injury? False: A bullet wound is an example of a "blast" wound which has an unpredictable trajectory and must consider path of tissue injury related to shock/stress waves. Name six life-threatning chest injuries: 1. Laryngeotracheal Injury/Airway Obstruction 2. Tension Pneumothorax 3. Open Pneumothorax 4.Flail chest and pulmonary contusion 5. Massive hemothorax 6. Cardiac tamponade What are the four pathophysiological consequenses of life-threatning chest injuries? 1. Hypoxia 2. Hypoventilation 3. Respiratory/metabolic acidosis 4. Inadequate tissue perfusion What alternative should you consider with an abusive and/or belligerant patient? Hypoxia (beyond intoxication of alcohol and drugs) Is cyanosis an early or late finding of hypoxemia? Late During a tension pneumothorax the mediastinal structures shift where? Opposite the affected side A needle thoracentesis is performed where anatomically? 2nd-3rd intercostal space, mid-clavicular line A tube thoracostomy (chest tube insertion) is performed where anatomically? 4th-5th intercostal space, mid-axillary line How should an open pneumothorax initally be managed? What should you be cautious of? Application of a sterile 3-sided dressing. Caution exercised to avoid creating an occlusive dressing which can lead to a tension pneumothorax. True or false: blood from a massive hemothorax can be transfused? True, autotranfusion can be done if a facility uses autotransfusion equipment.