139.A 29-year-old man presents to the ED after being stabbed in his neck. The
patient is speaking in full sentences. His breath sounds are equal bilaterally. His
BP is 130/75 mm Hg, HR is 95 beats per minute, RR is 16 breaths per minute,
and oxygen saturation is 99% on room air. The stab wound is located between
the angle of the mandible and the cricoid cartilage and violates the platysma.
There is blood oozing from the site although there is no expanding hematoma.
Which of the following is the most appropriate next step in management?
a. Explore the wound and blind clamp any bleeding site.
b. Probe the wound looking for injured vessels.
c. Apply direct pressure and bring the patient immediately to the OR to explore the
zone 1 injury.
d. Apply direct pressure and bring the patient immediately to the OR to explore
the zone 2 injury.
e. Apply direct pressure and bring the patient immediately to the OR to explore the
zone 3 injury.
140.A 45-year-old man is brought to the ED after a head-on motor vehicle col-
lision. Paramedics at the scene tell you that the front-end of the car is smashed.
The patient’s BP is 130/80 mm Hg, HR is 100 beats per minute, RR is 15 breaths
per minute, and oxygen saturation is 98% on room air. Radiographs of the cer-
vical spine reveal bilateral fractures of the C2 vertebra. The patient’s neurologic
examination is unremarkable. Which of the following best describes this
fracture?
a. Colles fracture
b. Boxer’s fracture
c. Jefferson fracture
d. Hangman’s fracture
e. Clay-shoveler’s fracture
Trauma 135