Chapter 34: Chest Trauma Flashcards
thoracic cavity
chest cavity, surrounded by the ribs, bordered inferiorly by the diaphragm
mediastinum
hollow area in the middle of the thoracic cavity between the right and left lungs, houses the trachea, vena cavae, aorta, esophagus, heart
cardiac box
rectangular portion of anterior chest framed by clavicles, midclavicular lines, and costal margin
visceral pleura
innermost layer of the lining of the thorax, in contact with lung
parietal pleura
outermost layer, in contact with thoracic wall
potential space
between pleural layers, negative pressure, acts like a vacuum
pneumothorax
collapsed lung due to puncture of visceral, parietal, or both pleura
open chest injury
result of a penetrating chest wound
intercostal muscles
muscles between the ribs
sucking chest wound
open chest wound that pulls air into pneumothorax with a noticeable sucking sound
tension pneumothorax
caused by air leaking into chest cavity from a damaged lung with no opening in the outer chest wall
closed chest injury
from blunt trauma applied to chest
flail segment
two or more adjacent ribs broken in two or more places, creates a segment of the chest that is unattached to the rest of the rib cage
paradoxical movement
the flail segment moving in an opposite direction to the movement of the rest of the chest wall
how to stabilize flail segment
CPAP or PPV with BVM and supplemental O2, only if patient shows signs of respiratory distress or failure
pulmonary contusion
bleeding within the lung tissue, often a serious consequence of flail segment or other blunt force injury
support for pulmonary contusion
high flow O2 via nonrebreather, CPAP, or PPV with supplemental O2
bleb
a congenitally weak area on the surface if the lung
spontaneous pneumothorax
a pneumothorax in the absence of trauma to the chest, usually from a bleb rupturing
open pneumothorax
result of an open wound to the chest created by a penetrating object, aka a sucking chest wound, air can be heard entering chest wound
hemothorax
thoracic cavity filled with blood
hemopneumothorax
collection if blood and air in thoracic cavity
traumatic asphyxia
when severe and sudden compression of the chest caused a rapid increase in the pressure in the chest, heart and lungs severely compressed, blood backflows out of right ventricle into head, shoulders, upper chest
cardiac contusion
common cardiac injury following severe blunt trauma to chest, occurs as heart is compressed between sternum and spinal column
commotio cordis
sudden cardiac arrest from blunt force applied to the precordial area of the anterior chest, often seen un young males, rare event, causes V-Fib, when the blow to the chest occurs at a vulnerable period in the cardiac cycle leading to a lethal dysrhythmia or the blow induces vasospasm of coronary arteries
pericardial tamponade
bleeding into the touch fibrous sac that surrounds the heart (pericardial sac),only needs small amount of blood, results in inward compression of heart, life threatening, most commonly caused by penetrating wound to heart
rib injury
most commonly fractured ribs are 3-8, usually on lateral aspect
considerations for MOI for chest trauma
- was the patient involved in a sports accident
- did the patient fall
- was there a fight
- is there any evidence that a shooting took place
- was the patient involved in an auto collision
- was the patient crushed between two objects
- was an explosion involved
subcutaneous emphysema
air trapped under the skin giving it a bubbly, inflated appearance and a crackling feel when palpated
jugular vein distention
indication of possible cardiac injury or tension pneumothorax
tracheal deviatoin
trachea moves to the side of the uninjured lung
hemoptysis
coughing up blood, blood-stained sputnum
general emergency care for chest trauma
- maintain an open airway
- administer a high concentration of oxygen
- reevaluate breathing status
- stabilize an impaled object in place
- provide spine motion restriction precautions if spinal injury is suspected
- treat the patient for shock (hypoperfusion) if signs and symptoms are present
emergency medical care for open chest wound
- immediately seal the open wound with your gloved hand
- apply an occlusive dressing to seal the wound
- continually assess the patient’s respiratory status
