Chest Trauma Mar 6 Flashcards
What are the different types of rib fractures?
Rib fractures and flail chest
Rib fractures can occur in various forms, including single fractures and multiple fractures leading to flail chest.
Define pneumothorax.
Partial or complete collapse of a lung due to either blunt or penetrating trauma
Most common cause of pneumothorax is rib fractures.
What is a simple pneumothorax?
When a lung collapses without the involvement of trauma
Usually caused by a congenital defect (bleb on the lung).
Identify the common demographic for spontaneous pneumothorax.
Tall, young (16-22), thin males who smoke
Marfan Syndrome is a condition that can contribute to spontaneous pneumothorax.
What are the signs and symptoms (S/S) of spontaneous pneumothorax?
- Pain
- Dyspnea
- Tachypnea
- Tachycardia
- Subcutaneous emphysema
- Unilateral chest rise
- Decreased/absent breath sounds
External trauma may also be a factor.
True or False: A sucking chest wound is caused by a penetrating wound through the chest wall.
True
What is the treatment for an open pneumothorax?
- Covered with an occlusive dressing secured with tape on 4 sides
- O2
- ECG
- IV therapy
- Transport
Open pneumothorax can lead to tension pneumothorax.
What is tension pneumothorax?
Occurs when air enters the pleural space but isn’t permitted to leave, causing lung collapse
This can put pressure on the mediastinum and the opposite lung.
What are the signs of tension pneumothorax?
- JVD
- Absent lung sounds on one side
- Profound hypoxia
- Altered LOC
- Loss of radial pulses
Tracheal deviation seen on a chest X-Ray is a late sign.
What is massive hemothorax?
The presence of 1000 mL or more of blood in the pleural space
Each thoracic cavity can hold up to 3000 cc of blood.
What is pericardial tamponade?
Accumulation of fluid in the pericardial sac causing compression of the ventricles
This results in a significant drop in cardiac output.
List the signs and symptoms of pericardial tamponade.
- Hypotension
- JVD
- Muffled heart sounds
- Weak/absent peripheral pulses
- Tachypnea
- Cyanosis
- Chest pain
Beck’s Triad includes hypotension, JVD, and muffled heart sounds.
What is flail chest?
Two or more ribs broken in at least 2 places resulting in paradoxical chest rise
Treatment includes standard care and possible intubation.
What is an aortic dissection?
A common cause of immediate death in motor vehicle collisions, usually from deceleration injury
Requires standard care and cannot be diagnosed in the field.
What are the signs and symptoms of pulmonary contusion?
- Diffuse chest pain
- Dyspnea
- Tachypnea
- Cyanosis
- Hemoptysis
- Decreased breath sounds
History of chest trauma is important for diagnosis.
What does myocardial contusion mimic?
Cardiac chest pain
It is lethal on its own and similar to an MI.
What is a diaphragmatic tear?
A complete or partial tear of the diaphragm usually due to penetrating trauma
It may allow intra-abdominal organs to enter the thoracic cavity.
What are the signs of a diaphragmatic tear?
- Abdominal pain
- Dyspnea
- Decreased breath sounds
- Bowel sounds in thorax
- Tachycardia
- Cyanosis
Loss of peripheral pulses and decreased LOC may also occur.
True or False: Isolated penetrating thoracic trauma is an indication for spinal motion restriction (SMR).
False
What does the study suggest about thoracolumbar immobilization in penetrating trauma?
It is almost never beneficial
Functional immobilization is often not achieved, and can lead to unnecessary complications.
