Emergency Medical Technician (EMT) Intermediate Practice Exam

What may indicate a tracheobronchial injury in a patient with blunt chest trauma?

1. Crepitus

2. Persistent cough

3. Subcutaneous emphysema

4. Difficulty speaking

The correct answer is: Subcutaneous emphysema

A tracheobronchial injury can occur as a result of significant blunt chest trauma and is characterized by certain clinical indicators. The presence of subcutaneous emphysema is a key sign that may suggest such an injury. This phenomenon occurs when air leaks from the tracheobronchial tree into the surrounding tissues, leading to the accumulation of air within the subcutaneous layers of the skin. As air continues to be trapped under the skin, it creates a characteristic crackling sensation upon palpation, often described as crepitus. This finding indicates a breach in the integrity of the airway structures, whether due to direct trauma or associated injuries. Other clinical signs, such as persistent cough or difficulty speaking, could also suggest airway compromise; however, they are not as definitive for tracheobronchial injury compared to subcutaneous emphysema. A persistent cough may arise from other causes, such as lung contusions or pneumothorax, and difficulty speaking is indicative of airway obstruction but is not specific to tracheobronchial damage. Therefore, the presence of subcutaneous emphysema is an important and telling sign in the setting of blunt chest trauma that warrants further evaluation for a potential tracheobronchial injury