Ch2 Trauma - Chest and lung

Question 1

Sign and Symptoms of Fractured Ribs/Clavicle (4)

Answer 1

1. Point tenderness
2. Anatomical Splinting (holding ribs with arm)
3. Painful shallow breathing.
4. Shortness of breath on exertion

Question 2

What is an unstable Chest wall ska flail chest (1)

Answer 2

2 or more ribs fractures in 2 or more places causing an unstable chest.

Question 3

What are the signs and symptoms of an unstable chest wall to look for? (5)

Answer 3

1. Pain and tenderness
2. deformity to the chest
3. respiratory distress
4. Possible paradoxical respiration
5. Signs and symptoms of Shock (hypoxia from lack of perfusion or oxygenated blood)

Question 4

What are the treatment principles for Chest Injury? (6)

Answer 4

1. Stabilize by immobilizing rib/clavicle fracture. Place patient in a position of comfort for breathing
2. Seal open chest wounds promptly using a commercial vented seal. occlusive dressing is okay if not a lung puncture.
3. consider pain management
4. Monitor for increasing shortness of breath (SOB) and for diminishing breath sounds
5. administer oxygen if available for SOB
6. EVACUATE

Question 5

What are the tree types of lung injury?

Answer 5

1. Pneumothorax
2. Hemothorax
3. Pneumohemothorax

Question 6

Air enters pleural space through a tear in the pleural linings, typically secondary to a rib fracture.

Answer 6

Closed Pneumothorax

Question 7

Air enters the Plural space through an open chest wound

Answer 7

Open Pneumothorax

Question 8

Air enters the pleural space from a spontaneous tear in the pleural .

Answer 8

spontaneous Pneumothorax

Question 9

Air enters the plural space compresses the lung and major vessels reducing lung and heart function.

Answer 9

Tension Pneumothorax

Question 10

This condition occurs when blood enters the Pleural space.

Answer 10

Hemothorax

Question 11

This condition occurs then a mixture of blood and air enter the pleural space.

Answer 11

Pneumohemothorax

Question 12

What are the sign and symptoms of a lung injury.(6)

Answer 12

1. Shortness of breath especially at rest.
2. Pain and tenderness.
3. Chest wall wounds, bruises deformity and instability
4. Shock-like vital signs elevated heart rate, elevated respiratory rate P/C/C skin
5. Subcutaneous Emphysema (air bubbles underneath skin.)
6. Diminished breath sounds(air) or wet breath sounds(blood) on injured side.

Question 13

What are the sign and symptoms of a serious lung injury.(6)

Answer 13

1. Respiratory Distress
2. Worsening Vital signs
3. Cyanosis
4. Worsening breath sounds
5. Jugular vein distention
6. Tracheal Deviation

Question 14

Treatment Principles for a lung injury (6)

Answer 14

1. Stabilize
   - immobilize rib or clavicle fracture
   - place patient with unstable chest wall in position of comfort to support breathing.
   - seal open chest wound promptly with commercial vented seal or use an occlusive dressing
2. Support breathing
   - Place patient in position of comfort, have them occasionally breath deeply to pain tolerance.
3. Consider pain management medications
4. Monitor for increasing shortness of breath and diminishing breath sounds.
5. Administer oxogen if available to help with shortness of breath
6. Evacuate