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Unstable chest injury during extrication — DipIMC MCQ

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HardTraumaUnstable chest injury during extricationDipIMC

A 60-year-old trapped driver has bruising across the sternum after a frontal impact. During extrication his systolic blood pressure falls from 118 to 80 mmHg, SpO2 drops to 89%, and air entry becomes reduced bilaterally after positive pressure ventilation is started. What is the most appropriate immediate action?

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Correct answer: B — Perform bilateral chest decompression while treating shock

Positive pressure ventilation can worsen occult pneumothoraces into tension physiology, especially with blunt chest trauma and sudden deterioration. Bilateral decompression is indicated in peri-arrest traumatic chest injury where laterality is uncertain. Imaging is not required before treating a life-threatening reversible cause.

Reference: Resuscitation Council UK traumatic cardiac arrest; ATACC