Chest Trauma

Question 1

What are the clinical features of chest injuries?

Answer 1

Penetrating trauma:
- entry & exit wound
- external bleeding
- internal bleeding

Blunt trauma:
- contusion / abrasion
- haematoma
- obvious rib fracture and / or clavicular fracture

Signs suggesting life threatening conditions:
- unequal air entry
- asymmetrical or paradoxical chest wall movement
- chest hypermobility
- bubbling or sucking wounds
- tracheal shift
- hypotension
- ALOC
- jugular vein distension
- muffled heart sounds
- cardiac dysrhythmias

Question 2

What is the standard management guideline for a patient with chest injury?

Answer 2

Signs of tension pneumothorax?
- Emergency chest decompression

Shock?
Yes - stabilise mechanical injuries & manage per hypovolaemic shock CPG

No:
- Stabilise mechanical injuries

Manage as per:
- O2
- IV access
- Analgesia
- IV fluid
- FAST

Question 3

What are the lethal 6 of thoracic trauma?

Answer 3

1. Airway obstruction
2. Tension pneumothorax
3. Open pneumothorax
4. Massive haemothorax
5. Cardiac tamponade
6. Flail chest

Question 4

What are the hidden 6 of thoracic trauma?

Answer 4

1. Tracheobronchial injury
2. Esophageal injury
3. Pulmonary contusions
4. Blunt cardiac injury
5. Blunt thoracic injury
6. Diaphragm rupture