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MMLU / A 22-year-old man is brought to the emergency department 30 minutes after he…

Problem

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question

A 22-year-old man is brought to the emergency department 30 minutes after he sustained a gunshot wound to the abdomen. His pulse is 120/min, respirations are 28/min, and blood pressure is 70/40 mm Hg. Breath sounds are normal on the right and decreased on the left. Abdominal examination shows an entrance wound in the left upper quadrant at the midclavicular line below the left costal margin. There is an exit wound laterally in the left axillary line at the 4th rib. Intravenous fluid resuscitation is begun. Which of the following is the most appropriate next step in management?

choices

  1. CT scan of the chest
  2. Intubation and mechanical ventilation
  3. Peritoneal lavage
  4. Left tube thoracostomy

subject

professional_medicine

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