7B: Multiple Traumas Flashcards
What are six cardiac complications due to trauma?
- Cardiac arrest
- Cardiac ischemia or infarct
- Cardiac tamponade
- Pericardial effusion
- Arrhythmias
- Cardiac contusion
When will cardiac arrest happen?
From the initial injury or due to the lack of O2
When will cardiac ischemia or infarct develop?
Initial injury or after some time
When will cardiac tamponade develop?
After time due to fluid around the heart
When will an arrhythmia develop?
From the initial injury, shock, result of blood volume issue, or lack of O2
What are the effects of cardiac contusion?
- Arrhythmias
- Blood volume issues
- V/Q mismatch
- Increased pressure
What are five pulmonary consequences of trauma?
- Pneumothorax
- Pleural effusion
- Rib fractures
- Lung contusion
- Pulmonary edema
What are the two types of pneumothorax?
Open or closed
When will pleural effusion occur?
Initially or after some time
What are the effects of lung contusion?
- Blood volume issues
- V/Q mismatch
- Increased pressure
What is included in the assessment following multiple traumas?
- Cardiopulm assessment, vitals
- Mobility and endurance
- Positioning
- Education
What are four interventions for multiple traumas?
- Address impairments
- Positioning, breathing
- Post trauma complications
- Activity tolerance, mobility
What are the effects of transections of the cervical spinal cord?
- Sympathetic info does not reach cardiovascular system
- Cannot increase HR and contraction force
- Decreased vasomotor control
Why is pulmonary venous insufficiency a concern with SCI?
Risk for orthostatic hypotension and shock
How is the pulmonary system managed in a pt with a C1-C2 SCI?
Ventilator dependent
How is the pulmonary system managed in a pt with a C3-C4 SCI?
- Ventilator-assist may eventually wean off to night time only
- Partial diaphragm innervation
- Use of high accessories
How is the pulmonary system managed in a pt with a C5-C7 SCI?
Ventilator assist initially
What are the impairments for a C1-T5 SCI?
- Bronchial hygiene
- Impaired ventilation volume
- Lack of sympathetic input
- Venous return
- Endurance
What are the impairments of a T6-S1 SCI?
- Mild endurance
- Impaired venous return
- Some lack of sympathetic
What are the three issues to be addressed during the acute phase?
- Wean off ventilator
- Improve respiratory status
- Improve inspiratory capability
What are you looking to maintain during the acute phase?
Chest mobility and compliance
What are you looking to strengthen and retrain in the acute phase
Diaphragm and accessory muscles
What type of breathing interventions are indicated for the acute phase?
Localized or segmental breathing
What equipment may be needed to assist a patient in the acute phases?
Corset and pneumobelt
What manual treatment may be required for a pt in the acute phase?
- Postural drainage with percussion
- Assisted coughing
What three issues are addressed in subacute or outpatient phases?
- Continuation of strengthening of accessory muscles and diaphragm
- Improve ventilatory capacity as much as possible
- Posture and balance control
What interventions are indicated for the subacute or outpatient phases?
- Postural and balance exercises
- Strengthening of accessory muscles, diaphragm
- Assisted coughing if needed
