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A 25-Year-Old Man Is Brought to the Emergency Department Following

question 331

Multiple Choice

A 25-year-old man is brought to the emergency department following a high-speed motorcycle collision. The patient is alert and in distress due to pain. Blood pressure is 84/52 mm Hg and pulse is 130/min. The airway is patent, the trachea is midline, and breath sounds are present bilaterally. Heart sounds are normal. There is bruising across the left chest wall, the lower abdomen, and the left flank. The abdomen is soft and mildly tender to palpation diffusely, without rebound tenderness. The bony pelvis is unstable to gentle downward pressure. The left lower leg is visibly deformed but distal lower extremity capillary refill is symmetric. There is blood present at the urethral meatus. Chest x-ray reveals multiple rib fractures without pneumothorax. Focused Assessment with Sonography for Trauma reveals no pericardial effusion or intraperitoneal free fluid. Portable anteroposterior pelvic x-ray is shown in the image below: $A 25-year-old man is brought to the emergency department following a high-speed motorcycle collision. The patient is alert and in distress due to pain. Blood pressure is 84/52 mm Hg and pulse is 130/min. The airway is patent, the trachea is midline, and breath sounds are present bilaterally. Heart sounds are normal. There is bruising across the left chest wall, the lower abdomen, and the left flank. The abdomen is soft and mildly tender to palpation diffusely, without rebound tenderness. The bony pelvis is unstable to gentle downward pressure. The left lower leg is visibly deformed but distal lower extremity capillary refill is symmetric. There is blood present at the urethral meatus. Chest x-ray reveals multiple rib fractures without pneumothorax. Focused Assessment with Sonography for Trauma reveals no pericardial effusion or intraperitoneal free fluid. Portable anteroposterior pelvic x-ray is shown in the image below: In addition to resuscitation with IV crystalloid and/or blood products, which of the following is the best next step in management of this patient? A) CT scan of the abdomen and pelvis B) Placement of a pelvic binder C) Plain radiographs of the left tibia and fibula D) Reduction of the lower leg deformity E) Retrograde cystourethrogram$ In addition to resuscitation with IV crystalloid and/or blood products, which of the following is the best next step in management of this patient?

Definitions:

Schizophrenia

An intense psychiatric disorder featuring disruptions in cognitive functions, perceiving reality, emotional state, linguistic abilities, self-conception, and behavioral patterns.

Onset

The beginning or start of something, often used in a medical context to describe the commencement of symptoms or a condition.

Diagnosis

The identification of the nature and cause of a certain phenomenon, typically concerning an illness or condition, based on its symptoms.

Season-of-Birth Effect

The hypothesis that the time of year a person is born can influence various aspects of their life and development.