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TRAUMA WEEK 1 A 20 year old man is brought to the ED following a bicycle accident, having ridden into a horizontal pole which struck his neck. He is conscious, alert, but very anxious. His respiratory rate is 35, systolic BP 100mmHg and has a swollen neck. He complains of severe pain to the neck and difficulty breathing. Describe your assessment (100%). A 50 year old amn is brought to your ED after an industrial accident that had fallen across the lower half of his body. On arrival to your ED he has a GCS of 15, BP of 100/60mmHG and is complaining of sever pain. Outline your assessment (50%). Outline your management (50%) 2007/1/SAQ8: An 18 year old intoxicated man is brought to your emergency department after diving into shallow water. He has examination findings consistent with a complete C6-C7 cord lesion. He has no other injuries. Describe your management (100%). 2005/1/SAQ6: The mother of a child makes a complaint. She states that three days previously, her 5 year old son had presented to the emergency department with elbow pain after a fall onto his outstretched hand. Following X-rays, the treating doctor had “pulled on the elbow several times causing him to cry”. The doctor stated that he had suffered a “sprained elbow” and to return if the pain did not settle. The mother is distressed that her son had received no analgesia for the sprain and that he continued to not move the elbow because of pain. She also complained that the doctor spoke in a rude and insulting manner, and was very rough in his examination. During your investigation, you find that the official report of the X-ray revealed a supracondylar fracture. Describe your management of this situation (100%). |
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TRAUMA WEEK 2 2006/2/SAQ2: In a patient with major pelvic trauma, describe the factors you would consider in deciding to use interventional radiology. (100%) 2003/2/SAQ2: A 25 year old prisoner is brought from the local prison by ambulance with a stab wound to the left neck. On arrival he is handcuffed to the ambulance trolley. He is muttering to himself, sitting upright, but talking with no obvious dysphonia or stridor. There is an obvious penetrating wound over the left mid sternocleidomastoid. Describe your assessment. (50%). Describe your management. (50%) 2007/2/SAQ2: Describe how the normal anatomical and physiological changes of pregnancy influence the assessment of a 32 week pregnant woman presenting with multiple trauma. (100%) 2001/1/SAQ3: A 17 year old male is involved in a high speed motor vehicle accident. He is hypotensive and tachycardic and you are having difficulty obtaining peripheral intravenous access. Discuss your options for obtaining rapid intravenous access in this situation (50%). Discuss the role of fluid resuscitation in this patient (50%) |
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TRAUMA WEEK 3 2004/1/VAQ7: A 38 year old man is brought in by ambulance. He was found unconscious in a house fire by the fire brigade. He is now conscious with spontaneous respirations and has O2 being delivered via a Hudson mask at 6L/min. He has a black sooty face and head. Both his hair and nasal hair are singed. He has carbonaceous spots on his tongue and pharynx. There is circumferential blistering to his left leg. Outline your management of this patient. (70%). Discuss the use of hyperbaric oxygen in this case. (30%) 2009/1/SAQ8: A 28 year old gas worker is brought to your emergency department having been injured in an explosion at work. On arrival in the emergency department he has the following vital signs; GCS: 10, HR: 120/min, BP: 125/75. Describe your assessment of this patient.(100%) 1999/2/SAQ4: A 24 year old male construction worker slips and falls astride on scaffolding. Outline your assessment and management of potential injuries (100%) 2008/1/SAQ4: A 7 year old girl is brought to your emergency department by ambulance following a moderate speed motor vehicle accident. She complains of a sore neck and tingling in her hands. She is currently lying on the stretcher crying, distressed and hyperventilating with no cervical immobilisation. The girl’s uninjured mother has accompanied her in the ambulance. Discuss the possible approaches to protecting her cervical spine pending further assessment. (100%) |
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2011/1/2: A 23 year old man is brought in to the emergency department by ambulance with an isolated stab wound to his left anterior chest. He is alert, sweaty and taking shallow breaths. The weapon is not in situ upon his arrival in the emergency department. His examination findings are; HR 105/min, BP: 95/60 mmHg supine, RR: 30/min, O2 Saturation: 93 %on room air. Describe your assessment (70%). Outline your management (30%). |
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2010/2/SAQ4: You are managing a 26 year old man from a motorbike crash. He has an isolated open book pelvic fracture. The patient has already received 2000ml of crystalloid and 6 units of blood. His vital signs are; GCS: 14, HR : 110/min, BP: 85/50mmHg supine, O2 Saturation: 98% on 15L/min O2 , Temperature: 34oCelsius. You are about to take the patient to interventional radiology for control of his pelvic bleeding. Describe your ongoing management of this patient during the procedure (100%). |
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2010/2/SAQ1: You have been telephoned by a 45 year old man who received treatment in you emergency department three days ago for neck pain after a motor vehicle collision. At that time, he was told the cervical spine X-rays were normal and was discharged home. His neck pain persisted, so his GP checked the hospital radiology result which reported a unifacet dislocation of C4 on C5. A) Describe how you would deal with this patient (50%). b) Outline other actions you would take in following up this error (50%). |
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2009/2/SAQ5: Describe the range of uses and utility of bedside ultrasound in the trauma patient. (100%) |
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2005/1/SAQ1: A patient presents with neck pain following a motor vehicle crash. Discuss what factors on history, examination and investigation you could use to clear the cervical spine. (100%) |
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2004/2/SAQ7: A 45 year old male is brought into the emergency department having attempted to hang himself with a belt in his bedroom. On presentation, he has a Glasgow Coma Score of 7. Outline the potential complications of this presentation. (50%). Outline your management of this patient (50%) |
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2003/2/SAQ6: A 36 year old skier is brought into your ED by helicopter paramedics. He has been found unconscious in a wooded area of the ski field. On arrival his pulse rate is 55 beats per minute in atrial fibrillation, his blood pressure is 110/70 and his GCS is 12. Describe your differential diagnosis (50%). Describe your management of this patient (50%). |
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2003/1/SAQ3: A 2 year old child presents by ambulance with 50% burns to the lower half of the body only. Describe your management of this child. (100%) |
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2002/1/SAQ5: An 18 year old male is brought to your ED by ambulance following a motor vehicle crash. He has been transported with a cervical collar in situ. Describe your assessment of the patient to allow safe and timely removal of his cervical collar (100%). |
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2001/2/SAQ6: An 8 y.o. female unrestrained rear seat passenger in high speed RTC where vehicle has rolled several times. She is transported by ambulance to hospital with oxygen, cervical collar and spine board. On arrival her P 120, BP 105/70, RR 40, GCS 15 and SaO2 99% on high flow oxygen. Examination reveals pain on springing her pelvis and suprapubic abdominal tenderness. X-Rays of her neck and chest are normal. X-Rays of her pelvis reveal a mixed vertical shearing and rotational injury with multiple fractures and bilateral sacroiliac joint disruptions. a) Outline your treatment of this patient on arrival (30%). b) Discuss the options available to detect the presence of intra- abdominal injury in this patient (70%). |
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2001/2/VAQ4: A 58 y.o. male self presents complaining of neck pain and arm weakness after a white water rafting accident. At triage he is placed on a bed and a cervical collar applied. He is haemodynamically normal, has a GCS 15 and is noted to have bilateral arm weakness. a) Describe your assessment of this man. b) Discuss the role of steroids in this patient’s treatment. |
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2001/1/SAQ8: A 23 year old man presents after falling 2 metres through a plate glass window. He is unconscious with a large shard of glass penetrating his left lateral thorax. He is also bleeding profusely from a deep laceration to the left upper arm. His pulse is 125/min and BP 90/60. Outline your assessment and management. (100%) |
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