A patient with history of chest trauma presents to the emergency depament with a BP of 90/70 mm Hg and a Pulse rate of 120/min. The patient is observed to be sho of breath using his accessary muscle of respiration. The JVP is not elevated. The most likely diagnosis is:
Correct Answer: Massive Hemothorax
Description: Answer is B (Massive Hemothorax): Features of Shock in a patient with Chest- Trauma without an elevated JVP suggest a diagnosis of Massive Hemothorax. Tension Pneumothorax Cardiac Tamponade Massive Hemothorax Simple Pneumothorax resenting Feature Respiratory Distress (Shock may be the presenting feature but less common) Shock (Shoness of Breath may be seen) Shock (Shoness of Breath may be seen) Shoness of breath may be seen No Shock (No Hypotension or Tachycardia) Neck Veins Distended Distended Not Distended Not distended Trachea Deted Midline Midline Usually Midline Breath Sounds Decreased or absent on side of injury Normal Decreased or absent on side of injury May be decreased on side of injury Percussion Note Hyper-resonant Normal Dull May be Hyper-resonant Hea Sound Normal Muffled Normal Normal
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