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INITIATION ROAD BLOCK EXAM

QUESTION 1.

A 58 year old man presents to your department by ambulance from a construction site after being hit in the chest and face by a large concrete block swinging from a pulley. His vital signs on arrival are:

HR 115/min
BP 99/66mmHg
RR 28/min
O2 sats 95% 6L VIA MASK

INITIATION ROAD BLOCK

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QUESTION 1: i. (4 marks) Give 4 signs on chest examination that may indicate the possibility of a pneumothorax. (4 marks) *

Question 2. The patient’s chest xray (shown left - click xray to open in a new window)is taken just after arrival. Give 2 major abnormalities from the film and the underlying diagnosis diagnosis. *

iii. (2 marks) After the patient’s xray returns he suffers increasing respiratory distress, de-saturates and has a cardiac arrest. What two actions would you immediately undertake? *

iv. (1 mark) After your actions above the patient regains immediate output but remains hypotensive with a systolic BP of 78mmHg. What volume resuscitation will you administer to this patient? *

v. (5 marks) Give 5 endpoints you would use to judge the efficacy of your volume resuscitation. *

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