Secondary survey

Question 1

What might you find in secondary survey in - B

Answer 1

simple pneumothorax
hemothorax
flail chest
pulmonary contusion

Question 2

What might you find in secondary survey in - C

Answer 2

Blunt cardiac injury
Traumatic aortic disruption

Question 3

What might you find in secondary survey in - E

Answer 3

Blunt oesophageal injury
traumatic diaphragmatic injury

Question 4

What precaution must be taken in simple pneumothorax if air transfer is to be considered

Answer 4

chest tube insertion, otherwise air pressure will cause tension pneumothorax

Question 5

How do you treat pulmonary contusion

Answer 5

monitor with arterial sats and end tidal co2
intubate if needed
judicious crystalloid therapy

Question 6

What ‘C’ injury are typically found on 2ry survey

Answer 6

blunt cardiac injury: cardiac chamber rupture
coronary artery dissection +/- thrombosis
myocardial contusion
traumatic asphyxia

Question 7

What mechanism usually causes traumatic aortic disruption

Answer 7

deceleration

Question 8

A 20 y/o man presents after a stab wound to the centre of his chest you find diminished breath sounds on the L side no rib # on cxr and some mediastinal air - what may be the underlying cause if these findingds

Answer 8

oesophageal injury

Question 9

What is the pathology beind traumatic asphyxia

Answer 9

SVC compression

Question 10

What findings may be presebt in traumatic asphyxia

Answer 10

upper body and face plethora and petichea +/- reduced GCS / seizures from cerebral oedema

Question 11

A 30 y/o woman presents with a stab wound the the lower part of her thorax, you hear deminshed breath sounds and n cxr you note a high gas bubble what could this indicate

Answer 11

diahragmatic injury

Question 12

What 2ry injury is associated with 10th and 11th rib injury

Answer 12

hepatosplenic