TCRN Exam Questions with 100% Correct Answers

Kehr's sign Correct Answer Referred left shoulder pain, usually indicates a splenic injury Base deficit Correct Answer Base deficit more than -6 indicates the need for agressive resuscitation and determination of the etiology CXR Correct Answer Most important tool providing useful information in the early minutes. Can identify major sources of blood loss from injuries in the chest or elevated diaphragm with displacement of abdominal organs Tracheobronchial injury Correct Answer Should be suspected if after chest tube placement a significant air leak is present Diagnostic Peritoneal Lavage Correct Answer Alternative to FAST scan to detect abd bleeding. A urinary catheter and gastric tube should be in place prior to procedure. FAST Correct Answer Focused Assessment with Sonography in Trauma. Used to detect free fluid in peritoneum or hemoperitoneum. Free fluid appears "black" on the screen. Has replaced DPL when available. Positive FAST scan Correct Answer Hemodynamically unstable trauma patient with a positive fast are taken directly to the OR for laparotomy Ultrasound abd exam Correct Answer Not useful to detect injuries to the diaphragm, intestine and pancreas. In patients with obesity, ascites and/or subQ emphysema the accuracy is reduced. CT scan Correct Answer Hemodynamically stable patients may be taken to CT Angiography Correct Answer Embolization is useful in treating patient with unstable pelvic fractures, liver and splenic hemorrhage. Use of hybrid OR suites to allow for surgical and interventional radiology methods of treatment simultaneously. Diagnostic laparoscopy Correct Answer Can be used to detect or exclude finding so f hemoperitoneum, organ injury, intestinal spillage or peritoneal penetration. Most useful in evaluating possible diaphragmatic injuries, espectially in penetrating thoracoabdominal injuries on the left site Diaphragmatic injuries Correct Answer Usually resultant of penetrating throacoabdominal injuries on the left side, including 11-12 rib fractures on the left.