Prehospital Trauma Life Support (PHTLS) Practice Test

What is the most likely cause of the patient's signs and symptoms after being struck in the chest with an object?

1. Tension pneumothorax

2. Simple pneumothorax

3. Pulmonary contusion

4. Hemothorax

The correct answer is: Hemothorax

When examining the most likely cause of a patient's signs and symptoms after being struck in the chest with an object, it is important to consider the mechanisms of injury and the typical presentations associated with each possible diagnosis. A hemothorax occurs when blood accumulates in the pleural space, often as a result of blunt or penetrating trauma to the chest. This can lead to symptoms such as chest pain, difficulty breathing, and decreased breath sounds on the affected side. The presence of blood in the thoracic cavity can compress lung tissue and impair gas exchange, resulting in respiratory distress and signs of shock due to significant blood loss. In the context of a blunt trauma, such as being struck by an object, the likelihood of vascular injury alongside other thoracic structures increases. This places hemothorax at a higher probability compared to other complications, particularly if significant force was involved that could tear blood vessels. While other conditions like tension pneumothorax, simple pneumothorax, and pulmonary contusion are also potential complications following chest trauma, their presentation and the underlying pathophysiological mechanisms differ. For example, tension pneumothorax tends to cause more rapid respiratory distress and a mediastinal shift, while a simple pneumothorax may