A 28-year-old man is shot in the right chest. His vital signs are: T 97.9, HR 120, BP 70/50, RR 12, SPO2 84%. He has significant JVD, his trachea is deviated to the left, and he has decreased breath sounds on the right.

The patient's diagnosis is:

1. Hypovolemic shock
2. Tension pneumothorax
3. Cardiac tamponade
4. Lung laceration
5. Spinal cord injury

Question

20-12-2023
Health

High School

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A 28-year-old man is shot in the right chest. His vital signs are: T 97.9, HR 120, BP 70/50, RR 12, SPO2 84%. He has significant JVD, his trachea is deviated to the left, and he has decreased breath sounds on the right.

The patient's diagnosis is:

1. Hypovolemic shock
2. Tension pneumothorax
3. Cardiac tamponade
4. Lung laceration
5. Spinal cord injury

Answer :

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dosarneha11 dosarneha11 · Answer 1 · 2024-03-21T23:47:06-04:00

Final answer:

Given the significant JVD, tracheal deviation, decreased breath sounds on the right, and overall clinical presentation, the patient's diagnosis is most consistent with tension pneumothorax. This is a critical medical emergency requiring immediate decompression to prevent fatal outcomes. Therefore the correct answer is 2).

Explanation:

This condition occurs when air enters the pleural space and cannot escape, leading to increased intrathoracic pressure, compression of the lung on the affected side, and shifting of the mediastinum to the opposite side which can compromise venous return to the heart and reduce cardiac output, manifesting in shock.

The key indicators for tension pneumothorax include JVD, tracheal deviation away from the affected side, hypotension, tachycardia, hypoxemia, and diminished or absent breath sounds on the side of injury.

Treatment involves the rapid decompression of the pleural space, often by needle thoracostomy followed by chest tube insertion to relieve the pressure and allow the lung to re-expand. It's crucial to address this condition immediately, as it can be rapidly fatal if not treated promptly.