EC Chp 27 Chest and Abdominal Trauma Flashcards
Chest and Abdominal Trauma
Chest injuries can include:
Blunt Trauma
Penetrating Objects
Compression
Compression injuries occur from
severe blunt trauma in which chest is rapidly compressed. Ex when driver strikes his chest on steering wheel or when person is trapped in trench wall collapse
Fracture of 2 or more adjacent ribs in two or more places that allows for the free movement of the fractured segment is a condition known as
Flail chest: it leaves a portion of the chest unstable and affects breathing and lung expansion leading to hypoventalation
Movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity is known as
Paradoxical motion
because maintaining positive thoracic pressure may reduce the degree of flail segment some systems allow the use of a noninvasive positive pressure ventilation for patients with Flail chests as long as they have…
Flail chests with an inadequate breathing.
Open chest wound usually means that not only is the skin broken but the…
chest wall is also penetrated. Ex bullet or a knife
when air enters the chest cavity from a open chest injury the delicate pressure balance within the chest is destroyed, This causes the lung on the injured side to…
collapse
Sucking chest wound is an open chest wound in which air is “sucked” into the chest cavity. The patient will develop…
severe difficulty breathing with signs showing:
- wound to the chest
- may or may Not be sucking sound
- gasping for air
with an Open Chest wound you should provide care in the following order:
- Maintain open airway
- Seal the open chest wound as quickly as possible
- Apply Occlusive dressing (at least 2in wider than wound)
- administer high concentration oxygen
- care for shock
- transport as soon as possible
Flutter valve dressing involves a…
3 sided occlusive dressing by leaving a side or corner unsealed to allow air that is trapped out of the chest
Blood vessels in the chest are largest in the body. Injuries to these are often fatal but can hold up to __ liters of blood and never spill a drop outside the body
3 liters
Air int he chest cavity (thorax area) possibly causing the collapse of a lung is called
Pneumothorax and will have diminished or absent lung sounds.
- uneven chest wall movement
- reduction of breath sounds
- distended neck veins
Tension Pneumothorax is a type of pneumothorax in which
air that enters the chest cavity is prevented from escaping. Ex. sealed occlusive dressing, closed chest wound
the results of a tension pneumothorax include
reducing cardiac out and lungs ability to oxygenate blood
a very late sign of pneumothorax and one that is difficult to detect is
trachea may shift to the opposite side
A condition in which the chest cavity fills with blood is called
Hemothorax
With a Hemopneumothorax the chest cavity fills…
with both blood and air
Hemothorax can be caused when
penetrating object or fractured ribs that cause lacerations within the chest cavity
The Sudden compression of the chest in which the sternum and the ribs exert severe pressure on the heart and lungs forcing blood out of the right atrium and up into the jugular veins in the neck is associated with
Traumatic Asphyxia
- patients neck and face will be darker color than rest of body
Traumatic Asphyxia signs include darker color to patients neck and face but also include
bulging eyes distended neck veins broken blood vessels in the face swollen blue tongue and lips chest deformity
Cardiac tamponade is when
An injury to the heart causes blood to flow into the surrounding pericardial sac and compresses the chambers to a point where they will no longer adequately fill, backing up blood into the veins
Distended neck veins, very weak pulse, low BP
signs of shock and narrowed pulse pressure are signs of what condition?
Cardiac Tamponade
Damage to the Aorta without trauma can be caused by Degeneration of the Aorta. Examples of this include:
high blood pressure or other diseases causes weakening of this large vessel causing to balloon and cause an aneurysm.
a Patient can have differences in pulse or blood pressure between right an left arms/legs
In proximal to aortic injury / in abdominal aortic injury
when someone gets hit in the center of the chest just when the heart is vulnerable which causes the heart to go into ventricular fibrillation is called
Commotio Cordis or (commotion/disturbance of the heart)
signs of Aortic Injury or dissection:
- Tearing Chest Pain
- Differences in Pulse or BP between right left extremities
- palpable pulsating mass (if abdominal aorta involved)
- Cardiac arrest
an intestine or other internal organ protruding through a wound in the abdomen is known as
Evisceration
A more common condition than evisceration is blunt trauma to one or more organs. the Most commonly injured organ is
the Liver because of its large size and position in the RUQ and under the lowermost ribs.
Two very very vascular organs that can cause life-threatening blood loss when injured are?
Liver (RUQ) and Spleen (LUQ)
When hollow abdominal organs such as the stomach, small and large bowels, gallbladder and urinary bladder are injured their contents will spill into the abdominal cavity causing…
severe irritation and often Peritonitis
Abdominal muscles can also involuntary contract leading to rigidity to abdominal wall
Pain, cramps, nausea, weakness, and thirst can be common signs of…
an Abdominal injury.
A patient with rigid or tender abdomen and tries to lie very still with legs drawn up in effort to reduce the tension are signs of what?
an Abdominal injury
For both closed and open abdominal injuries you should follow the necessary steps:
- Stay Alert for Vomiting
- Place Patient on back, legs flexed at the knees
- If there are signs of Hypoxia treat for shock
- Give NOTHING by mouth to the patient
- Monitor Vital Signs
- Transport ASAP
Do not touch or try to replace any eviscerated or exposed organs. Instead you should…
apply a sterile dressing moistened with sterile saline over the wound site to ensure the organs do not dry out.
A Patient who collapses in cardiac arrest after a force is applied to the center of his chest should still
receive CPR and defibrillation like any other arrest from cardiac cause
Closed chest wounds are sometimes difficult to distinguish or may occur together you should…
Asses the patient
including breath sounds, maintain ventilation and oxygenation.
