Chest Trauma Flashcards
What is the most common problem associated with Chest Trauma?
Hypoxia
This is due to impaired ventilation or secondary to hypovolaemia due to massive haemothorax or major vessel disruption.
Causes of Chest Trauma?
RTC Falls Crush Injuries Assault Blunt Force Gunshots Knife Wounds Blast Injuries
What may blunt trauma cause?
Fracrutes to clavical, sternum and ribs.
May cause tearing and contusions leading to pleurtic pain and lung damage.
How much fluid can accomodate the pleural space?
300mls
What is myocardial contusion?
Bruising of the heart.
How can you detect myocardial contusion?
ECG disturbances
What may penetrating trauma lead too?
Haemothorax, pneumothorax, cardaic tamponade
Types of injuries in chest trauma
Fractured ribs Flail chest Air embolism Pneumothorax Open chest wounds Tension pneumothorax Massive haemorhorax/ haemopneumothorax Cardiac tamponade Myocardial / pulmonary contusion Commotio cordis
Signs and symptoms of chest trauma
Dyspnoea Tachypnoea Pallor, cyanosis Tachycardia, muffled heart sounds JVD Hypotension Reduced/ absent chest sounds Hypo/hyper resonance Aysymmetry of chest wall
In trauma, dont forget…..
The back
Preferred handover method
A. T. M. I. S. T.
Respiratory assessment in chest trauma includes
Rate, depth and pattern
Auscultation for air entry
Percussion
Adminstration of high flow O2 regardless of SpO2 in major trauma
When should you consider assisting the patients breathing?
If SpO2 is lower than 90 on high flow oxygen
If the RR is below 10 or more than 30
Inadequate chest expansion
Positive pressure ventilation may exacerbate a penumothorax
What pain releif is contra indicated?
Entonox as it has a signifcant risk of enlarging a pneumothorax
What may morphine do?
Morphine may improve ventilation by allowing better chest wall movement but high doses may also induce respiratory depression
