Breathing Difficulties (Chest Injuries) Flashcards
List the types of chest injuries
- Flail segment
- Simple pneumothorax
- Open pneumothorax
- Tension pneumothorax
- Haemothorax
Define flail segment
Several ribs broken in more than one place causing a segment to the rib cage to detach from the main part
Define pneumothorax
The presence of air or gases in the pleural cavity.
Main types:
- Simple
- Open(sucking wound)
- Tension
Define simple pneumothorax
Small pneumothoraces(not under tension) are a frequent occurrence in patients with blunt chest trauma. It can be caused by direct injury to the lung(e.g. broken rib) or through barotrauma(pressure injury). It can also be caused by a leakage of air from a small spontaneous rupture in the lung surface, creating a build up of air in the pleural cavity. This “spontaneous pneumothorax” is more common in tall, thin young men.
Define open pneumothorax
In the case of a sucking wound, air is sucked into a lung and pleural cavity through an open chest during inspiration. Some of the air may bubble out of the wound when the patient exhales. It is usually a result from penetrating chest trauma and potentially creates a “sucking chest wound”. An open pneumothorax draws air into the pleural space thanks to a communication between atmospheric air and pleural space. Air enters the pleural space during chest expansion.
Define tension pneumothorax
A life-threatening condition that results from continued accumulation of air pressure in the pleural space. Eventually this causes compression of the heart and great vessels. Any pneumothorax can lead to a tension pneumothorax. Air enters the pleural cavity on the inspiration but cannot escape during expiration due to the presence of a one way valve formed by a pleural defect.
Define haemothorax
Damage to the lungs and the surrounding tissues causes bleeding into the pleural cavity. A haemothorax usually occurs as a result of torn lung tissue - either from blunt or penetrating trauma. Life threatening haemorrhages can occur as a result of severe lacerations of the lung, large vessels in the mediastinum or the heart - causing bleeding into the pleural cavity. Similar signs and symptoms to a pneumothorax, except one crucial difference - the effected side is dull on percussion.
What are the signs of a chest injury?
- Dyspnoea
- Panic and anxiety
- Cyanosis
- Haemoptysis
- Hypo/Hyper-resonance
- Pain at the sit of injury
- Tachycardia
- Tachypnea
- Asymmetry of the chest wall
What are the signs of tension pneumothorax?
- Tracheal deviation
- Extreme respiratory distress
- Severe pain
- Pulse pressure narrowing
- Increasing cyanosis
- Diminished breath sounds and hyper-resonance
- Possible signs of subcutaneous emphysema
Explain the management of chest injuries
- Check, clear and maintain the airway
- Give oxygen 100% - 15lt pm
- Assess breathing(use RISENFALL)
- Cover any wound with the chest seal
- Reassess breathing
- Complete primary survey
- Incline to injured side
- Evacuate ASAP
Explain how to position a casualty with chest injuries
If they are conscious place in the semi recumbent position(half sitting with injury side down). If they are unconscious in recovery position, injury side down
Treatment of tension pneumothorax
Needle thoracotomy - needle inserted into plural cavity to release tension within the cavity.
Describe the types of drowning
- Near drowning
- Dry drowning
- Fresh water drowning
- Salt water drowning
- Secondary drowning
Describe near drowning
- Occurs if the patient is rescued before point of death or if there is at least temporary survival
- Submersion
- Immersion
Describe dry drowning
- When a very small amount of water is aspirated into the back of the throat, causing the laryngeal muscle to spasm
- Causes death by suffocation
