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A young man crashes into a tree while skiing. He quickly develops shallow
and rapid breathing and complains of pain on the side of his chest that was
hit. Upon exposure of the chest wall, you visualize an open wound with
minimal bleeding but hear a sucking sound upon inhalation. He is alert and
did not hit his head, but is profusely sweating and pale. His breathing
seems to become more labored as you talk with him. His chest expands
more on the right than the left.
What should you do? - 🧠ANSWER ✔✔Place an occlusive dressing around
the wound and evacuate
You are hiking in a deep forest when you hear some screaming. You come
across a man clutching his abdomen. He has been mauled by a bear and
his shirt is stained with blood. You control all of the bleeding and examine
his abdominal region. You find sections of intestine protruding through one
of the lacerations from the bear.
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,What should be done for this injury? - 🧠ANSWER ✔✔Rinse intestines and
cover with moist cloth
You are hiking in the woods with a group of people when you hear some
shouts further up the trail. You find a man pinned under a tree that has
fallen. The tree is laying over the man's waist. As a group, you carefully
move the tree off the man. You find that he has significant bruising on his
hips and he confirms they feel very tender.
What is your plan? - 🧠ANSWER ✔✔Bind the hips with a sweatshirt
You are bouldering on some low level cliffs when you see a man fall and hit
his chest on a rock. Upon examining him, you find bruising and tenderness
over the right side of his chest. There is no bleeding and his chest is
expanding equally as he breaths. The man is experiencing difficult and
painful breathing, and starts to cough. After some time, bloody mucus
comes up with each cough.
What is this patient likely experiencing? - 🧠ANSWER ✔✔Pulmonary
contusion or hemothorax
A man hiking alone is struck in the back by a falling rock and knocked off
the trail. He is hurt but ends up walking back to his camp. The next
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,morning, he wakes up and finds that he has some blood in his urine. He
also has new, bluish bruising on the side of his lower back.
What is the likely diagnosis? - 🧠ANSWER ✔✔Retroperitoneal/renal
bleeding
You are camping in the mountains when you hear a woman scream. When
you get to her, you notice that she has fallen from a large rock, landing on a
small stick. She is complaining of abdominal pain and is holding her
abdomen. On exam, you find that she has a stick penetrating upwards in
her left upper quadrant.
Which of these structure is she most at risk of damaging? - 🧠ANSWER
✔✔Diaphragm
You and some friends are mountain biking on a forest trail. One friend
crashes into a tree, falls off his bike, and lands on his back. He does not
lose consciousness but immediately has trouble breathing. You open his
shirt to find part of the chest wall dropping inward as he takes a breath,
while the rest of his chest is expanding.
What is this condition and how do you treat it? - 🧠ANSWER ✔✔Flail chest.
Pad the area with a bulky dressing, wrap the area and evacuate
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, You and a friend are hiking near some cliffs. Your friend gets too close and
part of the cliff gives way. She falls about 20 feet, landing on the right side
of her body. You quickly get to her and find that she has injured the right
side of her chest. She is having some trouble breathing, but she seems to
be stable despite this. You make the diagnosis of broken ribs and a
possible pneumothorax and call for help on your cell phone. She suddenly
has more trouble breathing. She starts to lose consciousness and the veins
in her neck have now enlarged and are bulging out of the skin. The trachea
has shifted to the left.
What has happened? - 🧠ANSWER ✔✔She had developed a tension
pneumothorax
An 18-year-old runner trips while training and lands such that her abdomen
hits a rock. You are quickly on the scene. She has significant abdominal
pain in both the upper left and upper right quadrants of her abdomen, and
says it feels very tender. You recognize this as blunt trauma to the
abdomen, and you call 911.
What is the likely mechanism of injury and the organ(s) injured? -
🧠ANSWER ✔✔Compression injury to the liver and spleen
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