Cardiothoracic Trauma Flashcards
What is Resucitation’s acronym?
ABCDE
What does the primary survey include?
Resuscitation and treatment of life threatening injuries
What is the Secondary Survey?
Investigations and scans
What is the Tertiary survey?
Diagnosis phase
What is Surgical Emphysema
Presence of air in subcutaneous tissue
Surgical Emphysema treatment?
Goes away on its own, find root cause though
How do we diagnose Fractured Ribs?
X-ray
How do we Treat Fractured Ribs if more than 4 are broken?
Epidural Analgesia
Fractured ribs treatment if less than 4 are broken?
Intercostal nerve block
What do we always give for Fractured ribs?
Systemic analgesia
Why is a First Rib fracture particularly dangerous?
Because it may be associated with the brachial plexus or subclavian vessel injury
What is Flail Chest?
Paradoxial movement of a segment of the chest wall due to fractures
Typical cause of flail chest?
Blunt trauma
Investigations for Flail chest?
Chest x ray
Treatment for flail chest?
Oxygen, pain relief, internal chest wall stabilization,
Treatment of Sternum fractures?
Analgesia and follow up
What is Pneumothorax?
Presence of air in the pleural cavity
Primary spontaneous pneumothorax is caused by?
Ruptured apical bleb
Secondary spontaneous pneumothorax is caused by?
Pre existing long diseases
What causes Iatrogenic traumatic pneumothorax?
Surgical procedures like lung biopsies
Pneumothorax’ have complications, what are they?
Persistent air leak, Hemothorax: from the rupture of the vascular adhesion between lung and chest wall due
Tension Pneumothorax treatment
Chest tube drainage, inserted into 2nd space midclavicular line
Other treatment for pneumothorax?
Apart from the typical chest tubes, surgery and also Pleurodesis: the obliteration of the pleural space after lung expansion, via an inflammatory reaction
In Pleurodesis, the pleural space is obliterated via inflammation between the visceral and parietal pleura, what do we use to induce such reaction?
Tetracycline
Name indications of surgery for pneumothorax?
Prolonged leak, failure to expand, tension or bilateral. Essentially anything extreme
Explain hemothorax?
Blood in the pleural space
What is the most common cause?
Chest trauma
Numbers for mild hemothorax?
100-350ml
Moderate hemothorax numbers
350-1500ml
Numbers for severe hemothorax?
1500-3000ml
Hemothorax investigations?
Anemia, thoracentesis for the blood, and CXR
Treatment of mild hemothorax?
Aspiration under aseptic technique
Treatment for moderate to massive hemothorax?
Intercostal tube, between 5th and 6th space mid-axillary line.
Last resort treatment for hemothorax?
Thoracotomy
What is Pericardial’s tamponade’s biggest sign?
Beck’s Triad of. Jugular vein distension, hypotension, weak pulse
Pericardial tamponade treatment?
Pericardiocentesis
Simple Pneumothorax treatment?
Underwater seal at 2nd ICS at MCL
