EM Cases · Chest trauma
Chest trauma lethal six — resus station
ACEM Fellowship trauma resus testing tension decompression, sourced haemothorax thresholds, CRASH-2 timing, and PROPPR ratios.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A shocked blunt chest trauma patient with unilateral quiet chest and massive drain output.
Station brief
Format. Clinical-management (resus) station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant leading care.[4]
Candidate instructions. Manage the patient from handover. State actions and reasoning aloud. The examiner plays the nursing and specialty team.[4]
References4ShowHide
- [1]Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA, 2015.PMID 25647203
- [2]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2). Lancet, 2010.PMID 20554319
- [3]Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet, 2011.PMID 21439633
- [4]de Lesquen H, Avaro JP, Gust L, et al. Surgical management for the first 48 h following blunt chest trauma: state of the art (excluding vascular injuries). Interact Cardiovasc Thorac Surg, 2015.PMID 25476459