American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What interventions are indicated for significant bleeding with instability in a trauma scenario?

1. Cauterization

2. Balloon occlusion

3. Chest tube insertion

4. None of the above

The correct answer is: Chest tube insertion

In the context of significant bleeding with instability during a trauma scenario, the insertion of a chest tube is indicated primarily for cases of hemorrhagic pleural effusion or tension pneumothorax. When there is significant bleeding, especially from thoracic injuries such as rib fractures, lacerations of the lung, or injuries leading to pleural effusion, inserting a chest tube can help manage the situation by evacuating blood or air to relieve pressure on the lung and improve ventilation. This intervention is crucial as maintaining adequate oxygenation and perfusion is vital in a trauma patient who is unstable. Utilizing techniques like cauterization or balloon occlusion may not address the instability effectively; they are more suited for specific types of bleeding situations that may not be immediately life-threatening or in cases where control of bleeding is needed within a specific anatomical area. In the face of significant instability due to hemorrhage, the immediate concern is to ensure that critical functions such as respiration and hemodynamics are being supported, and chest tube insertion is a direct and effective intervention in such cases.