Scenario
A 4 year old boy arrives at your urban district emergency department one hour after falling from a playground slide. He opens his eyes to speech, uses inappropriate words and obeys commands (GCS 12).
The nearest neurosurgical service is twenty minutes away by road ambulance.
An image from his head CT scan is shown.
Question
a. Describe and interpret his CT scan. (30%) b. List the pros and cons of endotracheal intubation for this transfer (70%)
Answer
FACEM VAQ Exam 2007.1 – Question 8
- Overall pass rate for this question was 40/55 (72.7%).
- Scan showed a large L extradural haematoma with mass effect.
- The examiners felt that this was an excellent question backed by a high quality image.
- The CT scan description was generally well done.
- Major reason for poor scores on this question was failure to provide adequate reasons pro and con intubation in this case.
- Writing was particularly problematic to the examiners in interpreting the answers.
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