Scenario
A 25 year old man has been brought in to your emergency department after sustaining a knife wound to his neck in an assault. His vitals signs and GCS are normal.
Question
a. Describe his photograph (50%) b. List the likely associated injuries (50%)
Answer
FACEM VAQ Exam 2010.1 – Question 4
- The overall pass rate for this question was 57/70 (81.4%)
- Image: Large wound to lateral left side of the neck.
- Pass criteria:
- Mention of neck zones – 2 zones involved (contiguous including zone 2), deep/?platysma involvement.
- Adequate description of wound – large zigzag or Y shape from below tragus to lateral cricothyroid cartilage area..
- Preferably mention of blood soaked gauze, swelling (or tissue disruption below wound), blood splatter, ECG dot, pale appearance.
- Potential injury list needed adequate neurological (at least some nerves named e.g. vagus, rec laryngeal), vascular (jugulars/carotids minimum) and airway structures-(pharynx/trachea/larynx).
- Preferably also some mention of some other structures e.g. glands (thyroid/salivary) or muscles (SCM), oesophagus (preferred as a vital structure not to miss) or potential spaces (e.g: submental space).
- Features of unsuccessful answers:
- Inadequate description of wound, size/importance of wound, or zones involved.
- Inadequate or erroneous list of potential structures involved.
ACEM Fellowship Visual Aid Questions
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