Common Chest injuries

Question 1

Chest Injuries: ATOM FC

Answer 1

Airway injuries
tension pneumothorax (see resp medicine)
open pneumothorax
massive haemothorax
flail chest
cardiac tamponade

Question 2

Airways injuries;
- Indicated by ?, ? breathing and ? emphysema.
Management is as per ATLS;
o ? ?
o Examination / ?.
o ? airway.
o ? airway management (?).

Answer 2

stridor
noisy
subcut
jaw thrust
suction
temporary
definitive
intubation

Question 3

Open pneumothorax;

? communication between the pleural cavity and external ?.
o Will be obvious on examination, with a ‘?’ wound.
o ? ? can develop.

Answer 3

direct
environment
bubbling
tension pneumothorax

Question 4

Open Pneumothorax

Management;
o ? valve;
• Sterile dressing sealed on ? sides to create a ? through which air can escape but not enter.
o ? ?;
• Sited away from the wound itself.
o ? closure.

Answer 4

asherman
three
valve
chest drain
surgical

Question 5

Massive haemothorax;

> ?ml of blood within the pleural cavity.
Most commonly due to ? ? causing ? injury.
Signs are of ?, with lung ? when percussed with no ? signs.

Answer 5

1500
rib fracture
venous
shock
dull
breath

Question 6

Massive haemothorax

Management

Large ? ? placed in the ?th intercostal space, mid-? line
Admit for observation. ·
If there is continuous drainage of >?ml for ? consecutive hours the
patient should undergo ?.

Answer 6

chest drain
6
clavicular
200
4
thoracotomy

Question 7

Flail chest;

Multiple ? ? causing a ? segment.
o This characteristically will ? on inspiration.
This is very ?, so causes respiratory embarrassment.
o ?, ? breathing.

Answer 7

rib fractures
mobile
indraw
painful
rapid shallow

Question 8

Flail chest

There will be underlying pulmonary ?.
These patients require an ? ?/anaesthesia.
o If unable to cough away ?, they will get a ?.
If in respiratory failure or ?they may require ? ventilation

Answer 8

contusion
intercostal block
secretions
pneumonia
exhausted
mechanical

Question 9

Cardiac tamponade;

? into the ? cavity prevents ventricular filling, and thus there is a fall in cardiac ?.
Usually caused by ? trauma.
o Can occur in a ?, but the buildup of fluid is ? and thus
the heart is able to adapt.

Answer 9

bleeding
pericardial
output
penetrating
pericarditis
slower

Question 10

Cardiac Tamponade

? is diagnostic when Beck’s triad is seen on examination;
o Raised ?, low ?, ? heart sounds.
Management is immediate ? to relieve the pressure.
o ? will be needed as definitive management

Answer 10

echo
jvp
sbp
muffled
pericardiocentesis
thoracotomy