Chapter 14: Management of the Injured Patient

Chapter 14. Management of the Injured Patient

A 31-year-old man with a stab wound to the left neck over the sternocleidomastoid at the level of the lower pole of the thyroid gland

A. Has a wound in an area that is easily explored in the operating room as most injuries here can be identified and controlled directly.

B. Has a penetrating injury in zone 3.

C. Should have an initial assessment including airway, breathing and circulation.

D. Should be taken to angiography if unstable.

E. Has little risk of vascular injury.

The correct answer is C. Should have an initial assessment including airway, breathing and circulation

All of the following are correct about a patient with a systolic blood pressure of 75 torr after a rollover automobile accident that resulted in the death of another passenger except

A. Should be transported to a trauma center as expediently as possible.

B. Can have shock due to hypovolemia, cardiac failure, or neurogenic causes.

C. Should have an algorithmic approach to his care in the prehospital and trauma resuscitation phases of care.

D. Should bypass the trauma room and go directly to the operating room.

E. Has a mechanism of injury that places him at substantial risk of being severely injured.

The correct answer is D. Should bypass the trauma room and go directly to the operating room

Thoracic injuries

A. Are unusually contributors to the death of a trauma patient.

B. Can cause late deaths due to respiratory failure or sepsis.

C. Can include acceleration/deceleration as common mechanism of a severe aortic injury.

D. Carry a similar mortality in older and younger patients.

E. A, B, and C are all correct.

The correct answer is E. A, B, and C are all correct

Abdominal injuries

A. Can only be reliably assessed by CT scan or laparotomy.

B. Require laparotomy and repair for all identified liver parenchyma injuries.

C. Can routinely be evaluated by laparoscopy.