Cool Extremities in Surgery — 28yo Man | Trauma Surgery | SMLE Q#1393
SMLE Question #1393
Surgery
Trauma Surgery
Objective: OBJ-TRM-AIRWAY-01
Last updated: February 2026
A 28-year-old man is brought to the emergency department after a high-speed motor vehicle collision as an unrestrained driver. He has severe chest pain and dyspnea. He appears pale with cool extremities and sternal ecchymosis. Breath sounds are equal bilaterally. A supine chest radiograph shows a widened mediastinum and rightward tracheal deviation with no large pleural fluid level and no lung collapse. What is the most likely diagnosis?
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