TRAUMA · MEMBERSHIP SURGERY

Blunt splenic trauma — 34M RTA, FAST-positive transient responder

10 decision points ~22 min Difficulty 5/5 Membership

Setting

You are the trauma-team leader at a tertiary hospital with a hybrid theatre, 24-hour interventional radiology, blood bank and ICU. It is Saturday 15:00; MTP is active.

Patient

Mr M, a 34-year-old driver, arrives 45 minutes after a high-speed RTA. He was restrained. ATLS primary survey: airway patent, breathing symmetrical, circulation — BP 92/58 (after 1 L crystalloid en-route it was 118/72), HR 118, abdomen tender in the LUQ, seat-belt sign; GCS 14; no long-bone deformities. FAST is positive in Morison's pouch and the splenorenal window. He has received one unit of red cells.

Reference stack

Bailey & Love 28e Ch 35 · Sabiston 21e Ch 22 · WSES 2017 splenic trauma · AAST OIS · EAST 2012 splenic trauma

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.