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A 22-year-old man is hypotensive re-examine the chest
and tachycardic after a shotgun
wound to the left shoulder. His
blood pressure is initially 80/40 mm
Hg. After initial fluid resuscitation his
blood pressure increases to 122/84
mm Hg. His heart rate is now 100
beats per minute and his respiratory
rate is 28 breaths per minute. A tube
thoracostomy is performed for
decreased left chest breath sounds
with the return of a small amount of
blood and no air leak. After chest
tube insertion, the most appropriate
next step is:
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A construction worker falls two complete spine x-ray series
stories from a building and sustains
bilateral calcaneal fractures. In the
emergency department, he is alert,
vital signs are normal, and he is
complaining of severe pain in both
heels and his lower back. Lower
extremity pulses are strong and there
is no other deformity. The suspected
diagnosis is most likely to be
confirmed by:
Which of the following is true Evidence of improved perfusion after fluid
regarding the initial resuscitation of a resuscitation could include improvement in
trauma patient? Glasgow Coma Scale score on reevaluation.
In managing a patient with a severe secure the airway
traumatic brain injury, the most
important initial step is to:
A previously healthy, 70-kg (154- An ABG would demonstrate a base deficit between
pound) man suffers an estimated -6 and -10 mEq/L.
acute blood loss of 2 liters. Which
one of the following statements
applies to this patient?
The physiological hypervolemia of increasing the volume of blood loss to produce
pregnancy has clinical significance in maternal hypotension
the management of the severely
injured, gravid woman by:
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The best assessment of fluid urinary output of 0.5 mL/kg/hr
resuscitation of the adult burn
patient is:
The diagnosis of shock must include: evidence of inadequate organ perfusion
A 7-year-old boy is brought to the direct pressure on the wound
emergency department by his
parents several minutes after he fell
through a window. He is bleeding
profusely from a 6-cm wound of his
medial right thigh. Immediate
management of the wound should
consist of:
For the patient with severe traumatic cerebral vasoconstriction with diminished
brain injury, profound hypocarbia perfusion
should be avoided to prevent:
After being involved in a motor perform an exploratory laparotomy
vehicle crash, a 25-year-old man is
brought to a hospital that has
surgery capabilities available..
Computed tomography of the chest
and abdomen shows an aortic injury
and splenic laceration with free
abdominal fluid. His blood pressure
falls to 70 mm Hg after CT. The next
step is:
Which one of the following Leakage of amniotic fluid is an indication for
statements regarding abdominal hospital admission.
trauma in the pregnant patient is
TRUE?
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The first maneuver to improve administer supplemental oxygen
oxygenation after chest injury is:
A 25-year-old man, injured in a 9
motor vehicular crash, is admitted to
the emergency department. His
pupils react sluggishly and his eyes
open to pressure. He does not
follow commands, but he does moan
periodically. His right arm is
deformed and does not respond to
pressure; however, his left hand
reaches purposefully toward the
stimulus. Both legs are stiffly
extended. His GCS score is:
A 20-year-old woman who is at 32 perform needle or finger decompression of the
weeks gestation, is stabbed in the right chest
upper right chest. In the emergency
department, her blood pressure is
80/60 mm Hg. She is gasping for
breath, extremely anxious, and
yelling for help. Breath sounds are
diminished in the right chest. The
most appropriate first step is to:
Which one of the following findings respiratory rate of 40 breaths per minute
in an adult is most likely to require
immediate management during the
primary survey?
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