Blunt Chest Trauma Clinical Scenarios

A 22-year-old male was involved in an MVC. He is alert but anxious. Respirations are 28 and shallow. You note decreased breath sounds on the left side and unequal chest rise. BP is 118/76, pulse 110.

• Cardiac tamponade

• Simple pneumothorax

• Hemothorax

• Pulmonary contusion

A 30-year-old female was stabbed in the chest. She is in severe respiratory distress. You note JVD, hypotension, and absent breath sounds on the right.

• Massive hemothorax

• Cardiac tamponade

• Tension pneumothorax

• Pulmonary contusion

A patient fell from 15 feet. He has chest pain and increasing shortness of breath. Breath sounds are present but crackles are heard bilaterally. Oxygen saturation is dropping despite oxygen therapy.

• Pulmonary contusion

• Hemothorax

• Cardiac tamponade

• Flail chest

A 40-year-old male presents after blunt chest trauma. He is hypotensive, tachycardic, and has distended neck veins. Breath sounds are equal bilaterally.

• Hemothorax

• Cardiac tamponade

• Flail chest

• Pulmonary contusion

A trauma patient has paradoxical chest wall movement and severe pain with breathing. Oxygen saturation is 90% on room air. Which injury is MOST likely?

• Simple pneumothorax

• Hemothorax

• Flail chest

• Cardiac tamponade

A patient involved in a high-speed collision presents with diminished breath sounds on the left and signs of shock. There is no open wound. Which condition BEST explains both findings?

• Pulmonary contusion

• Simple pneumothorax

• Hemothorax

• Flail chest

Which finding MOST strongly suggests cardiac tamponade?

• Absent breath sounds on one side

• Paradoxical chest movement

• Narrowing pulse pressure with JVD

• Crackles in both lungs

A trauma patient suddenly becomes severely dyspneic. You note hypotension, tachycardia, and unilateral absent breath sounds. What is your PRIORITY?

• Splint fractures

• Apply high-flow oxygen

• Immediate transport

• Assist ventilations with BVM if inadequate

Which chest injury is MOST likely to worsen over several hours?

• Flail chest

• Pulmonary contusion

• Tension pneumothorax

• Cardiac tamponade

A patient presents with severe respiratory distress. Breath sounds are absent on the right. You also suspect significant blood loss into the chest cavity. Which condition is MOST likely?

• Simple pneumothorax

• Hemopneumothorax

• Pulmonary contusion

• Cardiac tamponade