BOOK4-CH10ThoracicTrauma

BOOK4-CH10ThoracicTrauma - Volume 4 Chapter 10 Thoracic...

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Volume 4 Chapter 10 Thoracic Trauma 1. The location of the neurovascular bundles containing the intercostals arteries is best described as the bundle that runs along the: a. Intercostal space equally distant from both associated ribs b. Posterior surface of the associated rib c. Inferior margin of the associated rib d. Superior margin of the associated rib 2. Which of the following are the most commonly fractured ribs? a. 7-12 b. 4-8 c. 5-10 d. 1-3 3. The finding of jugular venous distension in the pt with thoracic trauma is least likely to be associated with which of the following? a. Traumatic asphyxia b. Pericardial tamponade c. Tension pneumothorax d. Hemothorax 4. Which of the following is the primary concern in the pt with a hemothorax? a. Hypovolemia b. Atelectasis c. Mediastinal shift d. Increased intrathoracic pressure 5. Which of the following best describes the threat to life associated with traumatic rupture of the esophagus? a. Massive hemorrhage b. Entry of gastric contents into the mediastinum c. Hypoxia d. Decreased cardiacoutput 6. Your pt is a 27 year old male with one stab wound at the 5 th intercostals space posteriorly, on the right. He is ambulatory at the scene, but dyspneic, and has air movement at the site of the injury. Which of the following is the best sequence of actions in caring for this pt? a. Immediately apply an occlusive dressing, perform needle chest decompression at the 2 nd intercostals space in the midclavicular line, apply oxygen by NRB, begin transport, start two large bore IVs, and titrate to maintain BP above 100mmHg. b. Assist the pts breathing with a BVM, with the pt in a supine position to seal the wound; intubate, suing RSI if necessary, begin transport, and
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titrate two large bore IVs and titrate to maintain the BP pressure above 100mmHg c. Immediately cover the wound with your gloved hand, ask an assistant to prepare an occlusive dressing to be placed on the wound, apply oxygen by NRB, reassess the pts respirations, auscultate the lungs, assess the pulse, begin transport, and start two large bore IVs at a keep open rate as long as there are no indications of hypovolemia 7. You have just inserted a large bore catheter into the chest of a pt with a tension pneumothorax and received a return of air. Which of the following should NOT be done? a. Insert a 2 nd , or even a 3 rd , catheter if the pt is symptomatic despite the release of air b. Leave the catheter in place and create a flutter valve c. Remove the catheter d. Leave the catheter in place and open to air 8. Your pt is a 38 year old male who is pinned beneath the frame of a vehicle when it slipped off the makeshift jacks he was using to elevate it. The pts brother feels he may have been trapped for up to 20 minutes. The rescue unit is preparing to use airbags to lift the vehicle off the pt. Which of the following medications could you consider giving this pt? a.
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This note was uploaded on 03/25/2010 for the course PAR 100 taught by Professor Alan during the Spring '10 term at Miramar College.

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BOOK4-CH10ThoracicTrauma - Volume 4 Chapter 10 Thoracic...

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