Adult Critical Care Specialty (ACCS) Practice Exam

In the case of blunt chest trauma with shortness of breath, what intervention should be recommended upon assessment?

1. Increased supplemental oxygen

2. Insertion of a left chest tube

3. Immediate intubation

4. Chest physiotherapy

The correct answer is: Insertion of a left chest tube

In the context of blunt chest trauma accompanied by shortness of breath, the insertion of a left chest tube is a crucial intervention, particularly if there is evidence of a hemothorax or pneumothorax. Blunt chest injuries often lead to fluid accumulation in the pleural space, which can compromise respiratory function and gas exchange. The insertion of a chest tube allows for the drainage of blood, air, or fluid, thereby relieving pressure on the lung and facilitating re-expansion. This intervention is essential for restoring adequate ventilation and improving the patient's oxygenation status. While increased supplemental oxygen might provide temporary relief, it does not address the underlying issue of impaired lung expansion caused by the presence of air or fluid in the pleural space. Likewise, immediate intubation is generally reserved for patients who exhibit severe respiratory distress, altered level of consciousness, or failure of the breathing effort, rather than as a first-line treatment for the specific situation described. Chest physiotherapy, while beneficial in certain scenarios to enhance airway clearance, is not appropriate for managing acute complications arising from blunt chest trauma. In this case, addressing the mechanical issue with a chest tube is the most appropriate and necessary intervention.