Flail Ribs Flashcards
What percent of patients with chest wall injury have flail ribs
5-13%
Define trauma
Injury or wound that is caused by an external force
Two types of chest trauma
Penetrating
Blunt
Types of penetrating wounds
High velocity >1500 ft/s
Low velocity <1500 ft/s
What differentiates high velocity wounds from low velocity wounds
High- damages the organ and surrounding tissue
Designed to tumble or fragment as they travel
Low- damage tissue and generate bleeding at site
Two types of blunt chest injury
Acceleration/deceleration
Compression
Trauma assessment groups
American college of surgeons
Advanced trauma life support (ATLS)
Components of the ATLS survey
Airway
Breathing
Circulation
Disability
Expose
Female
Glucose
What MAP indicates adequate perfusion
Less or equal to 65 mmHg
Define shock
Failure of the circulatory system to maintain adequate perfusion to vital organs
Difference between obstructive vs hypovolemia
Obstructive: caused by cardiac tamponade and PTX mostly. Can be anything that decreases blood flow
Hypovolemia: blood pools and isn’t delivered to tissue
What Glasgow coma scale indicates intubation
<9
What is expose/environment include in the ATLS primary survey
Strip and examine
Environment: cover against cold
Score a patient using Glasgow come score scale
LOOK AT CAMERAROLL
What AVPU
Alert
Responds to Verbal stimuli
Responds to Painful stimuli
Unresponsive to stimuli
What is the Secondary survey ATLS
Head to tail assessment
Collect history
What does AMPLE stand for
Allergies
Medication
Past medical history/ Pregnancy
Last Meal/ or Intake
Events leading to present illness/ Environmental considerations
What does SAMPLE stand for
Signs/ symptoms
Allergies
Medication
Past medical history/ Pregnancy
Last Meal/ or Intake
Events leading to present illness/ Environmental considerations
When does a contusion start to blossom
Within 48hrs
Describe pulmonary contusion
A bruising of lung itself
Blunt force
Hemorrhage and alveolar relax
Chest images show focal consolidation
Define flail chest
Fracture of three or more ribs in two or more places
What causes compression injuries
Crush injuries
Primary blast injuries
Cause of acceleration/deceleration injuries
MVC’s
Falls
Sport injuries
How does flail chest increase WOB
As the patient inhales impaired side collapse
As they exhale stale air enter impaired (trapping)
How does Pendelufft develop
Stale air enters the impaired lung and mixes with good high oxygenated blood
How is flail chest diagnosed
Clinical diagnosis and imaging
What do you do for extreme flail chest
Surgery
What non-surgery practice can be done to stabilize chest wall
Apply pressure externally and reduce chest wall expansion.
Should chest flail patients require mechanical ventilation
59% due with leading complications being:
PNA
ARDS
Sepsis
Death
Role of invasive and non-invasive ventilation with flail chest
Distention the lungs open to prevent damage.
What does AVPU stand for
Alert
Verbal
Pain
Unresponsive
