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Your patient is a 55-year-old male who was found in the parking lot behind a tavern. He states that he was assaulted and robbed by three individuals. He is complaining of being "hit in the face and kicked and punched in his ribs and stomach." Your examination reveals contusions and swelling around both eyes, bleeding from the nose, a laceration of his upper lip, and multiple contusions of the chest, abdomen, and flanks. Which of the following should cause the greatest concern regarding the prehospital care of this patient?

A. Reducing the swelling around his eyes by applying a cold pack
B. The presence of any defensive wounds the patient may have sustained
C. Getting a description of the assailants
D. The possibility of a pneumothorax

1 Answer

4 votes

Final answer:

The greatest concern in the prehospital care of the patient is the possibility of a pneumothorax. This condition represents a potentially life-threatening emergency and should be prioritized over treating swelling or documenting defensive wounds.

Step-by-step explanation:

The question revolves around the prehospital care of a patient who has suffered assault resulting in multiple injuries. Among the listed concerns, the greatest one in terms of immediate prehospital care should be the possibility of a pneumothorax. A pneumothorax is a collection of air in the space between the lung and the chest wall (pleural space) that can cause the lung to collapse, leading to serious respiratory distress or even death if not promptly recognized and managed. Symptoms of a pneumothorax can include sharp chest pain, breathlessness, and rapid heart rate. In the context of trauma with multiple rib fractures, the likelihood of a pneumothorax is significant, making it more pressing than issues like swelling or identifying the assailants.

Other injuries described like the contusions and lacerations are also important, but these typically do not result in immediate life-threatening conditions to the same degree as a pneumothorax. While applying a cold pack can help reduce swelling, and noting defensive wounds can aid in clinical documentation and legal proceedings, addressing life-threatening conditions like a pneumothorax takes precedence in emergency medical care.