[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-533592-105":59,"doc-detail-533592-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","blunt-chest-trauma-best-next-step-in-management","Blunt Chest Trauma - Best Next Step in Management","","A hemodynamically stable adult with anterior chest wall pain after a high-risk motor vehicle collision shows normal oxygenation, normal heart and lung exam, and no acute findings on chest X-ray and eFAST. With blunt chest trauma and concern for blunt cardiac injury, the best management next step is ECG screening. Hemodynamic status guides evaluation: unstable patients need simultaneous resuscitation and imaging to detect life-threatening injuries.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/blunt-chest-trauma-best-next-step-in-management/533592/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/blunt-chest-trauma-best-next-step-in-management/533592.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is an ECG the best next step for this patient?","Question",{"text":112,"@type":113},"Blunt chest trauma can cause blunt cardiac injury even when oxygenation and initial imaging are normal. ECG screening helps identify cardiac injury early.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What clues support blunt chest trauma in this case?",{"text":117,"@type":113},"The patient has anterior chest wall bruising, pain, and painful respirations after a significant unrestrained motor vehicle collision, which raises concern for blunt chest trauma.",{"name":119,"@type":110,"acceptedAnswer":120},"How does hemodynamic stability change management in blunt chest trauma?",{"text":121,"@type":113},"In unstable patients, resuscitation and evaluation occur simultaneously (e.g., chest X-ray, eFAST, ECG) to look for life-threatening injuries. In stable patients, additional tests may follow (e.g., chest CT) to assess further injuries.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},533592,1791649549,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","1 of 40tion Id:12481Mark卡A AAPreviousNextExit ModeTutorialLab ValuesNotesCalculatorReverse ColorText Zoom  \n三×  \nA 22-year-old woman is brought to the emergency department by friends after she passed out at a party.They report that alcohol and multiplesubstances were available at the party but are not sure what the patient used.The friends have seen her use cocaine in the past.Bottles ofprescription alprazolam and hydrocodone are found in her handbag.The patient has no known history of medical conditions,and there is noevidence of trauma.On examination,she is stuporous.Temperature is 36.1C(97 F),blood pressure is 90/60 mm Hg,pulse is 110/min,andrespirations are 6/min.Pupils are 4 mm and reactive to light.Heart and lung examination is normal and bowel sounds are present.On neurologicexamination,the patient responds only to painful stimuli and has decreased reflexes bilaterally.Administration of naloxone has no effect.Whichof the following substances is the most likely cause of these findings?  \n○ A.Alcohol and benzodiazepines○ B.Alcohol and cocaine○ C.Alcohol and opiates  \n○ D.Benzodiazepines and phencyclidineO E.Benzodiazepines only  \nSubmit  \nSettings  \n# Explanation\n\nThis patient's presentation is consistent with a sedative-hypnotic overdose,most likely due to the combined effects of alcohol andbenzodiazepines.An isolated overdose of oral benzodiazepines can cause slurred speech,ataxia,hyporeflexia,and sedation.However,it isunlikely to cause this degree of CNS depression (most patients with isolated benzodiazepine overdose are still arousable),and vital signs typicallyremain normal.  \nGiven this patient's abnormal vital signs(eg,hypotension,severe bradypnea),coingestion of another sedative-hypnotic should be suspected,themost common being alcohol.Alcohol induces peripheral vasodilation and volume depletion (from diuresis)that can lead to hypotension(andcompensatory tachycardia),which is not commonly seen in isolated benzodiazepine overdose (Choice E).In addition,the synergistic effects ofalcohol and benzodiazepines cause profound CNS and respiratory depression,as seen in this patient.  \n(Choice B)Combined ingestion of alcohol and cocaine creates a metabolite called cocaethylene that prolongs and enhances the typicalsympathomimetic toxidrome of cocaine.Expected symptoms include dilated pupils,tachycardia,hypertension,and increased energy,notsomnolence and depressed respiratory drive.  \n(Choice C)Benzodiazepines taken with opiates can result in altered consciousness and respiratory depression.However,this patient's lack ofresponse to the opioid antagonist naloxone,her normal pupil size,and the presence of normal bowel sounds make opiate intoxication less likely.  \n(Choice D)Phencyclidine (PCP)intoxication most often causes severe agitation,psychosis,and aggressive behavior.The ingestion of abenzodiazepine with PCP may temper the latter's hyperadrenergic effects but would not be expected to cause significant CNS and respiratorydepression.  \n# Educational objective:\n\nIsolated benzodiazepine overdose can result in slurred speech,ataxia,and sedation,typically with normal vital signs.When profound CNSdepression,respiratory compromise,or vital sign derangements are seen,coingestion with other sedative-hypnotics/CNS depressants(eg,alcohol)should be suspected.  \n# Medical Library\n\nAlcohol use and its complications  \nBenzodiazepine use disorder  \nReferences  \n2 of 40  \n卡  \ntion Id:19889  \nExit Mode  \nPrevious  \nNext  \nTutorial  \nNotes  \nLab Values  \nCalculator  \nReverse Color  \nA 22-year-old previously healthy man is brought to the emergency department by ambulance after a motor vehicle collision.The patient wasunrestrained,and his vehicle sustained significant damage.The patient has anterior chest wall pain and painful respirations.Blood pressure is110/70 mm Hg,pulse is 110/min,respirations are 18/min,and oxygen saturation is 98%on room air.He is alert and oriented to time,place,andperson.Jugular venous pressure is normal.Anterior che","cbCaiuz6PpT9Bgq1","https://ap.wps.com/l/cbCaiuz6PpT9Bgq1","pdf",46210929,158,"English","# Scenario\n# Key Findings\n# Best Next Step in Management\n# Management Guided by Hemodynamic Status","[{\"question\":\"Why is an ECG the best next step for this patient?\",\"answer\":\"Blunt chest trauma can cause blunt cardiac injury even when oxygenation and initial imaging are normal. ECG screening helps identify cardiac injury early.\"},{\"question\":\"What clues support blunt chest trauma in this case?\",\"answer\":\"The patient has anterior chest wall bruising, pain, and painful respirations after a significant unrestrained motor vehicle collision, which raises concern for blunt chest trauma.\"},{\"question\":\"How does hemodynamic stability change management in blunt chest trauma?\",\"answer\":\"In unstable patients, resuscitation and evaluation occur simultaneously (e.g., chest X-ray, eFAST, ECG) to look for life-threatening injuries. In stable patients, additional tests may follow (e.g., chest CT) to assess further injuries.\"}]","Blunt Chest Trauma - Best Next Step in Management | PDF",1791592871,398]