06-11-2007, 04:29 PM
19. A 4-year-old boy is brought to the emergency department 20 minutes after being involved in a motor vehicle collision. He was an unrestrained passenger. On arrival, his blood pressure is 110/70 mm Hg, pulse is 100/min, and respirations are 32/min with grunting and retractions. Examination shows multiple bruises over the chest. Arterial blood gas analysis while breathing 40% oxygen shows:
pH 7.38
PCO2 34 mm Hg
PO2 66 mm Hg
An x-ray film of the chest obtained 4 hours later shows diffuse infiltrates on the right side. Which of the following is the most likely diagnosis?
A
) Acute respiratory distress syndrome
B
) Aspiration pneumonia
C
) Fat embolism
D
) Hemothorax
E
) Pulmonary contusion
pH 7.38
PCO2 34 mm Hg
PO2 66 mm Hg
An x-ray film of the chest obtained 4 hours later shows diffuse infiltrates on the right side. Which of the following is the most likely diagnosis?
A
) Acute respiratory distress syndrome
B
) Aspiration pneumonia
C
) Fat embolism
D
) Hemothorax
E
) Pulmonary contusion