Thoracic Injuries I

A 26-year-old motorcyclist has presented to your emergency department having been hit by a car. His airway is patent, and his spine immobilised. On chest examination, you detect RR 26, sats 94% on high-flow oxygen, crepitus suggesting rib fractures to his upper left side anteriorly, reduced breath sounds left side, resonance possibly increased left side. He has P 120 SR and BP 110/70.

Regarding his chest injury management, which of the following is the most appropriate next move?

A 17-year-old boy is a victim of an explosion and has an obvious open wound to his chest wall on the right. His airway is patent and he is talking. He has a C-spine collar in place. You remove a gauze dressing to reveal a 10 cm diameter chest wall defect in the posterior axillary line. Currently his RR is 40.

Which of the following management options would be inappropriate?

In preparation for chest drain insertion for anticipated large haemothorax, prime the underwater seal with which of the following options?

The paramedics report that a middle aged male has been stabbed to the left side of his chest. He suffers a PEA arrest on reaching your resus room. Select your best next move from the following?

Which of the following clinical feature combinations are near-universal for tension pneumothorax in awake patients?

A 52-year-old front seat passenger presents following a head on collision. His airbag was deployed. He has since walked and now complains of anterior chest pain only. You detect decreased breath sounds at the right apex. He is not short of breath and appears otherwise well. His chest x-ray is as demonstrated (image, right). Aside from addressing his analgesic requirements, which of the following management options is most sensible?

Which of the following statements regarding cardiac tamponade is false?