Difficulty: Medium
Average Score: 66%
Simulated
Passage / Scenario
HistoryA 40-year-old male is brought to the emergency department following a motor vehicle accident. He exhibits severe respiratory distress and has a history of blunt trauma to the chest.
Physical examination
On physical examination, you notice paradoxical movement of the chest wall: during inspiration, the affected segment of the chest wall moves inward, and during expiration, it moves outward.
His breath sounds are diminished on auscultation over the affected area, and he has a noticeable decrease in oxygen saturation.
What is the most appropriate initial management for this patient?
Correct answer
B
Rationale
Paradoxical chest wall movement indicates flail chest with likely pneumothorax, requiring needle decompression and chest tube insertion to stabilize the patient.