Chest Injury Flashcards
2+ ribs fx in 1+place; no longer attached to the thoracic cage.
Flail chest
Pt. breathes in, the intact chest wall expands & injured part is sucked in. Pt exhales: the chest wall moves in and the flail section moves out.
Usual cause: blunt trauma
Flail chest
Usual cause of Flail Chest and Rib Fractures
blunt trauma
Fx of ribs 1-3 take significant –> increased risk to
CNS, tracheobronchial, and vascular injuries
Most common ribs fractured
Ribs 5-9
–>Pos. laceration from fragments and jagged edges
On Scene Tx of Open Pnuemothorax
sterile occlusive dressing, 1-side untapped
Becks Triad
Decreased BP,
Muffled heart sounds
Distended neck veins
Acute widespread process of impaired cellular metabolism.
Shock (general)
Imbalance btwn supply & demand of O2 & nutrients
Shock (general)
Low Blood Flow Shocks
Cardiogenic
Hypovolemic
Left Sided Systolic Cardiogenic Shock–>
decreased systemic circulation
SCI @ T5 or above–>loss of SNS compensation/ vasoconstriction–>massive vasodilation leading to pooling of blood in vessels
Neurogenic Shock
Systemic inflammatory response to infection
Sepsis
Sepsis + hypotension despeite fluid resuscitation & inadequate tissue profusion
Septic Shock
Leading cause of death in non-coronary ICU
Septic Shock
4 stages of shock continuum
Initial
Compensatory
Progressive
Irreversible
Early S/S of Compensatory Stage of Shock
∆ in L.O.C. including: Restless, irritability, apprehension
HR Progressive stage shock
Tachycardia 100-150 bpm
Trauma Triad of Death
greatest risk of death in the first 24h d/t Hypothermia, Acidosis, Coagulopathy
MSOF
Multi-System Organ Failure aka MODS
MODS
Multi Organ Dysfunction Syndrome aka MSOF
Hallmark manifestation of overt GI bleeding
Hematemesis
Hematochezia
maroon-colored stools
Classic response to metabolic stress
use of protein for fuel
Prevacid, Nexium, Protonix
Proton pump inhibitors
Acute Gastrointestinal Ulceration=
Medical emergency
If unrecognized/TX too late = GI hemorrhage → hypovolemia
produce diffuse mucosal oozing
Stress ulcers
Zantac, Pepcid, Tagamet
H2 histamine blockers
Stress Ulcer onset
2-10d
black, tarry stool
Melena
Chronic