Trauma 1 SAQs
SAQ 1
A 32yo man has arrived in your rural emergency department having been involved in a
workplace
accident. An industrial guillotine has fallen on his left arm and severed his limb at the mid
forearm.
The ambulance describe significant blood loss at the scene and his stump has a shirt
tourniquet.
The severed extremity accompanies the patient. His vitals are:
PR 130
BP 80/60
RR 20
SaO2 97% RA
GCS 15
1.
List the six most important management priorities in this patient (3 marks)
2.
Describe your management of the severed extremity (3 marks)
3.
List your disposition options for this patient (2 marks)
4.
Justify the use of permissive hypotensive resuscitation in this patient (2 marks)
SAQ 2
Trauma in Pregnancy SAQ
You are the duty consultant at a major tertiary hospital. A call has come through from an ambulance
crew. They are 10 minutes away with a 26-year-old woman who is 34 weeks pregnant. She was the
driver of a car involved in a head on collision with another vehicle.
Her vital signs are: BP 110/80, HR 95, Sats 100% on 10L oxygen, RR 20.
Q1. Outline an example of an anatomical or physiological change of pregnancy’s impact on each of the airway ,
breathing and circulation resuscitation of a pregnant trauma patient (3 marks)
Airway
Breathing
Circulation
Q2: Outline two methods you might employ to assess the foetus in the setting of trauma (2 marks)
Trauma SAQ 2
A 14 year old boy presents via ambulance 1h following a collision with another player where they
collided heads during a football match. He was knocked out for 2 minutes. There was no reported
seizure activity. Currently he is complaining of a headache and nausea. Medical history reveals asthma
and concussion 2 years previous.
Examination findings:
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GCS 13 (E3M6V4)
No signs of basal skull #
2cm tender haematoma on forehead
PEARL
He cannot recall the incident or the game around it
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He is not orientated to time or place
He has no midline cervical tenderness
Q1. What are the key priorities in your assessment of this child? (2 marks)
Q2. Your intern asks you what the indications for a CT brain are in this age group. Summarise your
answer. (3 marks)
Q3. The patient’s parents hear you talking to the intern and are concerned about the radiation risk
of a CT brain. How would you address these concerns (2 marks)
Q4. What are the key priorities in management of this child? (3 marks)
Trauma SAQ 3
1. A 26 year old man has been brought to the Emergency Department following a motorbike
crash. His pelvic x-ray is shown below.
His observations are:
GCS
15
HR
110
BP
90/50mmHg
SaO2
98% on 15L/min O2
Temp 34
a. Describe and interpret the x-ray
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b. What are your 5 management priorities in this patient?
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c. Briefly discuss the insertion of an IDC in this patient noting indications and
contraindications.
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d. List the indications for interventional radiology in a patient with pelvic trauma
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e. What factors will influence your disposition of this patient
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Trauma SAQ 4
A 56 year old man is in the Emergency Department at 5pm following a motorbike collision.
He complains of pelvic pain and chest pain.
His observations are:
GCS
14
HR
98
BP
107/60mmHg
SaO2
96% on 15L/min O2
The patient reports that he takes warfarin for atrial fibrillation.
His pelvis x-ray is shown below.
f.
Describe and interpret the x-ray.
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g. What preconditions would you want met prior to removing the binder?
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h. Briefly outline the different types of pelvic fractures.
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i.
List techniques for haemorrhage control from pelvic fractures that can be applied in
the Emergency Department.
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j.
How would you reverse this man’s warfarin?
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Trauma SAQ 5
A 43 year old man has presented following a fall with neck pain. He is reports numbness
from his axillae down. His BP is 90/40.
His CT is shown below:
k. Please describe and interpret the CT image.
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l.
What are the potential causes of the hypotension?
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