A 52-year-old man is brought to the Emergency Department after a hanging. He was found in PEA arrest with ROSC after 10 minutes of advanced life support and intubated prehospital. A chest X-ray is performed on arrival.

Hanging

1. State the most likely pathology demonstrated and give three pertinent findings seen on the chest X-ray. 4 marks

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His vital signs are as follows : GCS 3 HR 105 BP 88/54 Sats 89% FiO2 1.0

2. State two treatment measures you would institute including end points. 2 marks

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3. Apart from the pathology shown, list four potential complications of this presentation and a supportive finding on examination for each. 4 marks

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Shortly after arrival, the patient’s ventilator has begun to display a high-pressure alarm.

4. List three possible causes of a high-pressure ventilator alarm and give your management for each. 3 marks

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The patient’s family have arrived.

5. State five key components of your discussion with the family. 5 marks

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