Hemo/pneumothorax Flashcards

1
Q

Essentials of Diagnosis for Hemothorax

A

Decreased breath sounds, dullness to percussion on affected side. Respiratory distress and hypotension.

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2
Q

Physical findings for what?
(a) Respiratory distress, tachypnea, variable degrees of hypoxia.
(b) Dullness to percussion, decreased breath sounds on affected side.
(c) Hypotension and flattened neck veins depending on degree of blood loss.
(d) Pulse pressure narrow.
(e) Smaller illnesses may be difficult to detect in supine patients because of gravity.

A

Hemothorax

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3
Q

Diagnosis confirmed by_____. Volumes of blood as low as ______ may be seen on upright of this imaging modality.

A

chest X-ray
200- 300mL

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4
Q

What can be used to evaluate for hemothorax at bedside quickly

A

Ultrasound

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5
Q

DDx for hemothorax
Must consider causes of chest pain and dyspnea

A

(a) Cardiac
(b) Pulmonary
(c) Trauma
(d) GI
(e) Musculoskeletal
(f) Psych

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6
Q

Tx for Hemothorax

A

(a) Ensure patient has an intact airway.
(b) Oxygen to correct hypoxia.
(c) If the airway is not intact, provide suctioning and intubation if necessary.
(d) Tube thoracotomy with a 36 or 40 French chest tube.

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7
Q

Disposition of hemothorax

A

MEDEVAC

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8
Q

Essentials of Diagnosis for Pneumothorax

A

Absent or decreased breath sounds, hyper resonance to percussion on affected side

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9
Q

_______ is the abnormal collection of air within the pleural space

A

Pneumothorax

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10
Q

Pneumothorax is classified as what?

A

spontaneous (primary or secondary)
traumatic (chest trauma or iatrogenic)

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11
Q

_______ pneumothorax occurs in patients without clinically apparent lung disease

A

Primary spontaneous

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12
Q

Pneumothorax
Typically, young, tall, men age 20-40 who smoke? It is thought to occur from ______

A

rupture of subapical blebs.

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13
Q

_________ pneumothorax occurs as a complication of preexisting underlying
pulmonary disease.

A

Secondary pneumothorax

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14
Q

Secondary pneumothorax what is the possible underlying causes

A

1) COPD
2) Pneumonia
3) CF
4) Asthma
5) TB
6) Pneumocystis carina pneumonia infection.

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15
Q

WHAT must always be considered in trauma patients.

A

Traumatic pneumothorax is common

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16
Q

would you consider Traumatic pneumothorax as a complication in some invasive procedures
a) Subclavian line placement
b) Thoracentesis
c) Lung or pleural biopsies.
d) Barotrauma from positive pressure ventilation.

A

yes

17
Q

These are PE for What?
(a) Pleuritic chest pain, tachypnea, tachycardia.
(b) Chest pain ranging from minimal to severe and dyspnea occur in almost all patients.

A

Pneumothorax

18
Q

In small pneumothorax (15% of one Hemothorax or less) physical findings may be _______.

A

minimal

19
Q

In a larger pneumothorax what would be some physical findings

A

diminished breath sounds
decreased tactile fremitus
decreased chest movement
hyper resonance on affected side

20
Q

_____ imaging will reveal most pneumothoraces

A

Chest X-ray

21
Q

Demonstration of a visceral pleural line is diagnostic, may only be seen on an (expiratory/Inspiratory) film.

A

Expiratory

22
Q

DDX for pneumonia
Must consider causes of chest pain and dyspnea

A

(a) Cardiac
(b) Pulmonary
(c) Trauma
(d) GI
(e) Musculoskeletal
(f) Psych

23
Q

Tx for Pneumothorax
Ensure patient has an intact airway. If the airway is not intact, provide ______ and _____ if necessary.

A

suctioning
intubation

24
Q

True/false
Treatment depends on size of the pneumothorax and the patient’s stability

A

True

25
Q

Stable or unstable?
1) RR <24/min, HR 60-120/min, BP normal, O2 Sat >90%.
2) Able to speak in sentences.
3) Obtain chest X-ray in 3-6 hours and compare with arrival Chest X-ray.

A

Stable

26
Q

Tx for pneumothorax

A

Ensure intact airway
-If the airway is not intact, provide suctioning and
intubation if necessary
O2
For a large pneumothorax or unstable patients, re-expansion of the lung is necessary
-Chest tube
Treat symptomatically for cough and chest pain

27
Q

Disposition for pneumothorax

A

MEDEVAC

28
Q

What is a complication for pneumothorax

A

Tension pneumothorax