Chest & Abdominal Trauma Terminology Flashcards
hemothorax
accumulation of blood in the pleural space
- may be massive: 2-3mL
- dullness on percussion
- narrow pulse pressure
- hypotension/hypovolemia
- no JVD
tension pneumothorax
accumulation of air in the pleural space
- JVD
- hyperresonance on percussion
- subcutaneous emphysema
- hypotensive (late stages) - obstructive shock
similarities of hemothorax/tension pneumothorax
- tachypnea
- dyspnea
- cyanosis
- diminished or decreased breath sounds
- tracheal deviation (late sign)
- asymmetrical chest rise
deviation
“a departure from the normal”
narrow pulse pressure
“when your pulse pressure is less than 25% of your systolic bp”
what does JVD stand for?
jugular vein distention
JVD
“large vein in neck bulges visibly”
hyperresonance
“an exaggerated chest resonance heard in various abnormal pulmonary conditions”
subcutaneous emphysema
“rare condition that occurs when air or gas accumulates under the skin, where it’s not normally present”
flail chest
“two or more adjacent ribs are fractures in two or more places”
adjacent
“close to or near something”
signs of flail chest
- bruising
- tenderness
- crepitus
- paradoxical motion with inspiration and expiration (late sign)
paradoxical motion
“chest wall moves in on inspiration and out on respiration, in reverse of the normal movement”
management of flail chest
- SPO2 and ETCO2 monitoring
- assist ventilations to achieve SPO2 > 94%
- consider CPAP
- contact ALS for advanced airway management
CPAP
“machine that uses mild air pressure to keep breathing airways open (while you sleep)”
cardiac tamponade
when 25mL of pericardial fluid is in between the visceral pericardium (innermost lining) and parietal pericardium (middle lining)
- excess fluid that builds up in the pericardial sac (puts pressure on heart which prevents it from filling and pumping like needed)
- causes cardiogenic or obstructive shock
- often occurs due to blunt trauma (ex: steering wheel to chest)
pericarditis
“swelling and irritation of the thin, saclike tissue surrounding the heart”
neoplasm
“a new and abnormal growth of tissue in some part of the body”
management of tamponade
- ABC’s
- oxygen
- contact ALS
Beck’s Triad
triage of key signs of tamponade
- JVD
- muffled heart sounds
- hypotension
other signs of tamponade
- chest pain
- dyspnea
- orthopnea
- narrowing pulse pressure
- electrical alternans
- pulsus paradoxus
- altered LOC
orthopnea
“dyspnea that happens when when you’re lying on your back”
electrical alternans
“alternating QRS amplitude in any or all leads on an ECG with no additional evident changes in conduction pathways of the heart”
pulsus paradoxus
“when your bp decreases with inhalation”
evisceration
protrusion of (an) internal organ(s) or the peritoneal contents through a wound
peritoneal
“the tissue that lines the abdominal wall and covers most of the organs in the abdomen”
management of evisceration
- cover eviscerated contents with moist, sterile dressing
- cover moist dressing with dry dress to conserve organ temp
- never attempt to place organs back in cavity
solid organ injury
- rapid and significant blood loss
solid organs most injured?
- liver
- spleen
liver
largest organ in abdominal cavity
spleen
left upper quadrant
- 40% of patients have no immediate symptoms
- Kehr’s Sign (pain in left shoulder)
hollow organ injury
- spillage of contents is primary concern (sepsis, wound infection, abscess formation)
hollow organs?
- stomach
- colon
- small intestine
stomach injury
not often injured by blunt trauma
colon and small intestine injury
more likely to be injured by penetrating trauma than blunt trauma
sepsis
“life-threatening medical emergency that occurs when the body’s immune system has an extreme response to infection”
abscess formation
“a collection of pus surrounded by tissue that forms when the body’s immune system tries to fight an infection”
management of abdominal trauma
- stabilize patient and rapid transport
- position of comfort
- oxygen
- check for other injuries
- reassess every 5 minutes
dyspnea
“shortness of breath”
pulse pressure
“difference between systolic and diastolic bp”
chest resonance
“the vibration in the chest cavity that occurs when someone speaks or sings”
