Your patient is a 17-year-old male driver of a vehicle that received a lateral impact at the driver's side door. There are no side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door. Your patient is complaining of left shoulder pain and pain "in his left side." He has a contusion on the left shoulder and deformity of the left clavicle. He has erythema over the left lateral thorax from ribs 6 through 12 with crepitus on palpation. Which of the following injuries should you suspect?
1. Blunt trauma to the spleen
2. Blunt trauma to the liver
3. Penetrating trauma to the spleen
4. Penetrating trauma to the liver
5. Left pneumothorax
6. Fracture of the left clavicle
A) 1, 2, 6
B) 2, 4, 6
C) 1, 5, 6
D) 2, 5, 6
C
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A patient who enters the emergency department has an exacerbation of COPD complicated by pneumonia. The patient is hemodynamically stable, demonstrates a strong cough, and has ABG data consistent with respiratory failure. Which of the following therapeutic interventions would be appropriate at this time?
A. endotracheal intubation and a T-piece B. endotracheal intubation and invasive positive-pressure ventilation C. negative pressure ventilation D. noninvasive positive-pressure ventilation
When a patient has pneumonia, which of the following would be found in the alveolar effusion fluids?
1. Mucus 2. Serum fluid 3. Saliva 4. Red blood cells a. 1, 3 b. 2, 4 c. 2, 3 d. 1, 2, 3, 4