7B: Multiple Traumas

Question 1

What are six cardiac complications due to trauma?

Answer 1

1. Cardiac arrest
2. Cardiac ischemia or infarct
3. Cardiac tamponade
4. Pericardial effusion
5. Arrhythmias
6. Cardiac contusion

Question 2

When will cardiac arrest happen?

Answer 2

From the initial injury or due to the lack of O2

Question 3

When will cardiac ischemia or infarct develop?

Answer 3

Initial injury or after some time

Question 4

When will cardiac tamponade develop?

Answer 4

After time due to fluid around the heart

Question 5

When will an arrhythmia develop?

Answer 5

From the initial injury, shock, result of blood volume issue, or lack of O2

Question 6

What are the effects of cardiac contusion?

Answer 6

• Arrhythmias
• Blood volume issues
• V/Q mismatch
• Increased pressure

Question 7

What are five pulmonary consequences of trauma?

Answer 7

1. Pneumothorax
2. Pleural effusion
3. Rib fractures
4. Lung contusion
5. Pulmonary edema

Question 8

What are the two types of pneumothorax?

Answer 8

Open or closed

Question 9

When will pleural effusion occur?

Answer 9

Initially or after some time

Question 10

What are the effects of lung contusion?

Answer 10

• Blood volume issues
• V/Q mismatch
• Increased pressure

Question 11

What is included in the assessment following multiple traumas?

Answer 11

• Cardiopulm assessment, vitals
• Mobility and endurance
• Positioning
• Education

Question 12

What are four interventions for multiple traumas?

Answer 12

1. Address impairments
2. Positioning, breathing
3. Post trauma complications
4. Activity tolerance, mobility

Question 13

What are the effects of transections of the cervical spinal cord?

Answer 13

• Sympathetic info does not reach cardiovascular system
• Cannot increase HR and contraction force
• Decreased vasomotor control

Question 14

Why is pulmonary venous insufficiency a concern with SCI?

Answer 14

Risk for orthostatic hypotension and shock

Question 15

How is the pulmonary system managed in a pt with a C1-C2 SCI?

Answer 15

Ventilator dependent

Question 16

How is the pulmonary system managed in a pt with a C3-C4 SCI?

Answer 16

• Ventilator-assist may eventually wean off to night time only
• Partial diaphragm innervation
• Use of high accessories

Question 17

How is the pulmonary system managed in a pt with a C5-C7 SCI?

Answer 17

Ventilator assist initially

Question 18

What are the impairments for a C1-T5 SCI?

Answer 18

• Bronchial hygiene
• Impaired ventilation volume
• Lack of sympathetic input
• Venous return
• Endurance

Question 19

What are the impairments of a T6-S1 SCI?

Answer 19

• Mild endurance
• Impaired venous return
• Some lack of sympathetic

Question 20

What are the three issues to be addressed during the acute phase?

Answer 20

• Wean off ventilator
• Improve respiratory status
• Improve inspiratory capability

Question 21

What are you looking to maintain during the acute phase?

Answer 21

Chest mobility and compliance

Question 22

What are you looking to strengthen and retrain in the acute phase

Answer 22

Diaphragm and accessory muscles

Question 23

What type of breathing interventions are indicated for the acute phase?

Answer 23

Localized or segmental breathing

Question 24

What equipment may be needed to assist a patient in the acute phases?

Answer 24

Corset and pneumobelt

Question 25

What manual treatment may be required for a pt in the acute phase?

Answer 25

• Postural drainage with percussion
• Assisted coughing

Question 26

What three issues are addressed in subacute or outpatient phases?

Answer 26

• Continuation of strengthening of accessory muscles and diaphragm
• Improve ventilatory capacity as much as possible
• Posture and balance control

Question 27

What interventions are indicated for the subacute or outpatient phases?

Answer 27

• Postural and balance exercises
• Strengthening of accessory muscles, diaphragm
• Assisted coughing if needed