Question 1

A 24-year-old male presents to the trauma bay with a stab wound to the left anterior chest and is hypotensive. How will you
manage this patient?
Key Discussion Points
a.Most probably, inadequate perfusion is from a pump problem.
b.Necessity for early diagnosis of cardiac tamponade.
c.Tension pneumothorax can have similar signs and symptoms as cardiac tamponade.

Question 2
After you have identified cardiac tamponade in a patient who presents with a penetrating chest injury, how will you manage
this patient?
Key Discussion Points
a.Emergency department thoracotomy and control of hemorrhage.
b.Operative repair of cardiac injury.
c.Postoperative management and evaluation.

Question 3
A 37-year-old male truck driver is involved in a frontal impact motor vehicle crash. He presents to the trauma bay intubated
with two large-bore intravenous catheters in bilateral antecubital fossas. The patient is hemodynamically labile (heart rate is
130, systolic pressure 80 mm/Hg, diastolic pressure 40mm/Hg). The patient is pale, has distended neck veins and a soft
abdomen, and ATLS protocol has been initiated. A FAST evaluation is performed that demonstrates pericardial fluid but no
intra-abdominal fluid. How should this patient be managed?
Key Discussion Points
a.Indications for FAST.
b.Management approach for a patient who after substantial injuries from a frontal
c.Specific procedure and operative intervention requirements.