Paramedic National Registry Practice

What is an indication of a pulmonary contusion in a trauma patient?

1. High BP and low pulse

2. Flail chest and coughing blood

3. Decreased respiratory rate

4. Absence of breath sounds

The correct answer is: Flail chest and coughing blood

A pulmonary contusion is a bruise of the lung tissue resulting from trauma, typically caused by blunt force injury to the chest. When a patient suffers from a pulmonary contusion, it can lead to bleeding within the lung tissue, resulting in coughing up blood, also known as hemoptysis. The presence of a flail chest, which is characterized by multiple rib fractures resulting in a segment of the rib cage moving paradoxically during breathing, often co-occurs with pulmonary contusions as both can stem from severe blunt trauma to the chest. Coughing up blood (hemoptysis) is a direct indicator of damage within the respiratory system, while the flail chest indicates a significant injury to the chest wall that often accompanies lung injury. Thus, the combination of flail chest and coughing blood serves as a clear clinical indication of a pulmonary contusion, marking it as the appropriate choice. The other choices do not present typical indications of a pulmonary contusion. High blood pressure and low pulse might suggest different cardiovascular issues, decreased respiratory rate can be associated with various conditions but is generally not specific for pulmonary contusion, and absence of breath sounds may indicate other severe pulmonary issues, such as tension pneumothorax or large pleural effusions