Scenario
A 15 year old boy is injured in a high speed motor vehicle crash.
He was resuscitated at a local hospital and has just arrived in your emergency department. He was intubated, ventilated and resuscitated at a local hospital.
A chest X-ray was taken on arrival.
Question
Describe and interpret his chest X-ray. (100%)
Answer
FACEM VAQ Exam 2005.2 – Question 4
- Overall pass rate for this question was 31/56 (55.4%)
- The chest X-ray shows an intubated patient with bilateral chest tubes, multiple rib fractures, lung contusion and fractured clavicle.
- There were many abnormalities to detect on this xray but examiners felt this was emergency medicine “core business” and so expected a high standard.
- The fractures, lung opacification, various lines/tubes all needed to be noted.
- It was then also expected that this would be synthesized into important diagnoses that shoudnt be missed (eg aortic injury) as well as the diagnoses that had been made (eg bony injuries) and the future problems that could be anticipated (eg impaired gas exchange). Some candidates failed by overreading the xray to report false positive findings.
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