4.6 of 5 Ratings
A 45-year-old male presents to the emergency department following a 5-car motor vehicle collision requiring mechanical extraction. On arrival to the ED, his airway is patent with normal breathing. His pulse is 110/min, blood pressure is 85/40 mmHg, respirations are 22/min, and oxygen saturation of 98% on room air. He is in clear distress and has the findings shown in Figure A. A chest radiograph and ultrasound examination are performed, which are shown in Figures B and C respectively. It is noted that his systolic BP decreases by 15 mmHg whenever he inspires. Which of the following diseases can exhibit a similar manifestation?
Congestive heart failure
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A 34-year-old patient is brought to the emergency room after a motor vehicle accident. An EKG shows sinus tachycardia and chest radiograph reveals an enlarged cardiac silhouette. While observing sinus tachycardia on the patient's telemetry, you note that the radial pulse cannot be palpated during inspiration. What should be the next step in management of this patient?
Chest CT scan
Insert chest tube
A 27-year-old male arrives in the emergency department with a stab wound over the precordial chest wall. The patient is in distress and is cold, sweaty, and pale. Initial physical examination is significant for muffled heart sounds, distended neck veins, and a 3 cm stab wound near the left sternal border. Breath sounds are present bilaterally without evidence of tracheal deviation. Which of the following additional findings would be expected on further evaluation?
Decrease in the patient's heart rate by 15 beats per minute with inspiration
Elevated blood pressure to 170/110
Steadily decreasing heart rate to 60 beats per minute
15 mmHg decrease in systolic blood pressure with inspiration
Decrease in central venous pressure by 5 mmHg with inspiration