Chest Pain in Surgery — 64yo Man | Trauma Surgery | SMLE Q#11549

SMLE Question #11549

Surgery Trauma Surgery

Objective: OBJ-TRM-AIRWAY-01

Last updated: February 2026
A 64-year-old man is brought to a small rural hospital after a high-speed motor vehicle collision. He has a closed head injury but is awake and oriented, with chest pain and mild shortness of breath. Chest radiograph shows a widened mediastinum and fractures of left ribs 2–5, with no pneumothorax. The nearest trauma center is 40 km away. What is the most appropriate next step before transferring this patient?

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