Injuries to chest, abdomen, pelvis

Question 1

mc mechanisms for injury to the chest

Answer 1

blunt trauma
crushing injury
penetrating injury

Question 2

s/s of chest injury

Answer 2

• Difficult breathing
• pain
• bruising
• deformity
• cyanosis
• coughing up blood
• obvious signs of injury

Question 3

s/s of pneumothorax

Answer 3

• sudden sharp chest pain, made worse by a deep breath or a cough
• sob
• chest tightness
• easy fatigue
• rappid HR
• bluish color of the skin caused by lack of O2
• Nasal flaring
• anxiety, stress, tension

Question 4

What should u do for further eval of pneumothorax and what are the finding s

Answer 4

stethoscope exam of the chest reveals decreased or absent breath sounds on affected side

Question 5

Hemothorax and mc cause

Answer 5

collection of blood in the space bw the chest wall and the lung
-mc cause is chest trauma, doesn’t occur spontaneously

Question 6

overall first aid for blunt trauma (closed chest injury)-

Answer 6

Check- the scene
Call- 911/EMS (if sig injury/difficult breathing)
Care- Ensure ABCs, Secondary survey

Question 7

first aid overall of puncture wound

Answer 7

Ensure ABCs

• immediatly seal the open wound w glove hand (to limit any external air exchange to reduce risk of collapse)
• apply a occlusive dressing to seal wound (3 of 4 sides taped down)
• continually assess the Pts status

Question 8

how should pt be pos in a puncture wound

Answer 8

pos the pt so the blood is able to drain and escape

Question 9

What is flail chest + what is it associated w

Answer 9

• injury to the ribs where a section of the chest wall has been detached due to multiple fractures
• gnerally an associated collapsed lung
• life threatening condition

Question 10

s/s of flail chest

Answer 10

• pale, cool clammy skin
• rappid weak pulse
• shallow/difficult to breath
• paradoxical chest mints
• cyanosis/shock

Question 11

first aid continual care for flail chest

Answer 11

stabilize them-> place on flail side down or in a seated pos, using that arm to provide support to the injured side

• decrease pain + tx for shock
• PRICE
• hospitalization
• 6-8w rib healing

Question 12

general symptoms of appendicitis

Answer 12

• hard to dx in children, elderly and childbearing w
• pain may be vague, but becomes increasingly sharp and severe
• reduced appetite, nausea, vommiting, low grade fever
• pain in L R quad

Question 13

physical exam + findings for appendicitus

Answer 13

• ask pt to cough (localize where pain is)
• mc burnies point local tenderness
• feel for mm rigitity
• rebound tenderness
• rosvings sign (pain of L palp)

Question 14

what is the mechanism you willl see for spleen injuries

Answer 14

mc from blunt trauma

-also penetrating trauma to LUQ

Question 15

s/s of spleen injuries

Answer 15

LUQ abdominal pain
radiation to left shoulder
shock
hypotension
association w lower rib fx
40% w sig hemoperitoneum

Question 16

what is the mc associated organ damage w pelvic fx

Answer 16

MC bladder

Question 17

pt to ER with pelvic fx= what is the mortality rate

Answer 17

3%

Question 18

Pt to ER with pelvic fx and hypotension= mortality rate

Answer 18

38% mortality rate

Question 19

urethral injury is mc associated w what

Answer 19

usually associated w pelvic fx with external force (95% will have urethral involvement)

Question 20

s/s of urethral injuries

Answer 20

Inability to urinate

• abdominal or pelvic pain
• Small/weak urine stream
• blood at meatus

Question 21

what % of all injuries to pelvis lead to bladder injury

Answer 21

50% of all crush injuries

Question 22

s/s of bladder injury

Answer 22

• blood at urethral opening
• painful urination
• distended abdomen
• neusea and vomitting
• increase in temp/chills

Question 23

first aid of contusions to the testes

Answer 23

have pt lie down and bring knees up to chest and tell to relax (resolution in a few mins)

-give proper home instructions- educate them on signs to look for- swelling , discolouration, blood coming from meatus, bloody urine

Question 24

what is torsion of spermatic cord and mechanism

Answer 24

• can occur after direct or indirect impact to scrotum
• dull pain, heavy feeling
• testicle spins on itself around spermatic cord and epididymis
• can occur from vig sex

Question 25

physical exam of torsion of spermatic cord

Answer 25

scrotum will look very swollen, tight, red

• looks like epididymis and inf
• mc in late teens/early 20s