133.An 18-year-old man presents to the ED after getting stabbed in his
abdomen. His HR is 140 beats per minute and BP is 90/40 mm Hg. He is
yelling that he is in pain. Two large-bore IVs are inserted into his antecu-
bital fossa and fluids are running wide open. After 2 L of fluids, his BP does
not improve. Which of the following is the most common organ injured in
stab wounds?
a. Liver
b. Small bowel
c. Stomach
d. Colon
e. Spleen
134.A 61-year-old man presents to the ED with chest wall pain after a motor
vehicle collision. He is speaking full sentences, breath sounds are equal bilat-
erally, and his extremities are well-perfused. His BP is 150/75 mm Hg, HR is
92 beats per minute, and oxygen saturation is 97% on room air. Chest radi-
ography reveals fractures of the seventh and eighth ribs of the right anterolat-
eral chest. He has no other identifiable injuries. Which of the following is the
most appropriate treatment for this patient’s rib fractures?
a. Apply adhesive tape on the chest wall perpendicular to the rib fractures
b. Insert a chest tube into the right thorax
c. Bring the patient to the OR for surgical fixation
d. Analgesia and incentive spirometry
e. Observation
135.A 27-year-old man bought to the ED by paramedics after a motor
vehicle collision. His RR is 45 breaths per minute, oxygen saturation is
89%, HR is 112 beats per minute, and BP is 115/75 mm Hg. You auscultate
his chest and hear decreased breath sounds on the left. Which of the fol-
lowing is the most appropriate next step in management?
a. Order a STAT chest radiograph
b. Perform a pericardiocentesis
c. Perform a DPL
d. Perform an ED thoracotomy
e. Perform a tube thoracostomy
Trauma 133