香港专科考试试题 2009 年三月第三题

shenxiu2

A 4 years old child who is involved in a household fire from a faulty air-conditioner with minor explosion is scheduled for emergency surgery. He sustains a penetrating injury to his right eye and an open fracture of his right forearm. On examination, he is alert, crying incessantly and obviously in pain. His vital signs include heart rate 160/minutes, respiratory rate 36/minutes, blood pressure 110/54 and SpO2 98%. He has no significant past history and has his meal 3 hours ago.

1) What are the priorities in the initial evaluation and management of this child? What further information would you need prior to taking him to theatre?

2) How would you determine if he has sustained an inhalational injury? Describe your management of inhalational injury in this patient.

3) Thirty minutes into operation, pulse oximeter alarms “pulse search”, blood pressure monitor reads “error” and electrocardiogram depicts sinus tachycardia. You cannot feel any pulse. What are your differential diagnoses and how would you manage this situation?

Hong Kong Board exam question 2009 March

shenxiu2

1# shenxiu2
这题目是考题,欢迎大家讨论.用中文讨论也行.

王麻子

1 IV access should be established. If there is significant active bleeding, bilateral large bore (20G or greater) cannulae should be placed.Cardiovascular instability，no pulse ,blood loss is continuing.
2airway stimulus:dyspnea,asthma .

QIULIANGCHENG

使看不懂啊，怎么办呢？

QIULIANGCHENG

请个专业翻译人员吧

ivylinshuying

我们这里考中级的题目了

怡然自得

大概看懂了，但是用英语回答还有点难:) 发表一下观点，请各位指教：
第一问：1.止痛的同时控制气道（是否有呼吸道烧伤？2.扩容

怡然自得

第二问：如有呼吸道烧伤，选择气管切开
第三问：是否出现创伤性休克？