Emergency Medical Technician (EMT) Intermediate Practice Exam

A fracture of the first and second ribs due to severe blunt trauma is most likely to result in which injury?

1. Cardiac injury

2. Pneumothorax

3. Tracheobronchial injury

4. Hemothorax

The correct answer is: Tracheobronchial injury

A fracture of the first and second ribs from severe blunt trauma can indeed lead to serious complications, one of which is a tracheobronchial injury. The rationale behind this is that these upper ribs are in close proximity to vital structures within the thoracic cavity, including the trachea and bronchi. When these ribs fracture, the sharp edges or fragments can potentially lacerate or cause a significant injury to these airway structures. Injuries to the tracheobronchial tree are serious and can lead to life-threatening conditions, including respiratory distress due to airway compromise. These types of injuries may not always be immediately evident and can manifest with symptoms such as subcutaneous emphysema, cough, or difficulty breathing. Understanding this context highlights the importance of evaluating for tracheobronchial injuries in patients with upper rib fractures, especially when they occur due to significant blunt force trauma. Other possibilities, such as pneumothorax or hemothorax, are indeed associated with rib fractures but are more commonly linked to lower rib injuries or penetrating trauma. Cardiac injury, while a risk with rib fractures, is less directly related to the first and second ribs compared to tracheobronchial injuries.