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CH 35 Chest Trauma > Lecture PPT > Flashcards

Lecture PPT Flashcards

1
Q

Is the paramedics goal in chest trauma

A

Early recognition, aggressive treatment, rapid transport

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2
Q

Respiratory control center in the brainstem monitors concentrations of what

A

pH or CO2

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3
Q

Increase in pH or PaCO2 causes what

A

increase rate and depth of respiration

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4
Q

What respiratory rates cause concern in the chest trauma patient

A

30

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5
Q

The assessment of chest trauma OBSERVATION

A 
Airway open
Rate and depth of respiration's
Use of accessory muscles
Bilateral movement
Paradoxical motion
JVD
Skin color
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6
Q

The assessment of chest trauma PALPATION

A 
Pulse central compared to periphery
Stability
Crepitus
Paradoxical motion
Sub Q emphysema
Tenderness
Equal chest rise and fall
Tracheal deviation
Percussion
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7
Q

Assessment of chest trauma AUSCULTATION

A 
Upper airway sounds
Lower airway sounds
Assessed early
Monitor for changes
Volume inspired
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8
Q

Rib fractures most commonly occur to what ribs

A

3-8

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9
Q

Rib fracture signs and symptoms

A 
Pain with breathing
Pain with movement
Local tenderness
Crepitus
Possible hypoventilation and bleeding
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10
Q

Rib fracture management

A

Oxygen

Encourage deep breathing splint

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11
Q

Anticipated complications of a rib fracture

A

Pulmonary contusion
Pneumothorax
Hemothorax
Laceration of intercostal vessel

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12
Q

Characteristics of The flail chest

A

Two or more adjacent ribs fractured in two or more places

Paradoxical movement

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13
Q

Signs and symptoms of a flail chest

A

Painful
Crepitus
Paradoxical motion
Hypoventilation

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14
Q

Flail chest management

A

Assist ventilations with PPV if possible
Consider RSI or sedation
Split the flail segment

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15
Q

Characteristics of a simple pneumothorax

A

Air in the plural space

Pleural pressure causes partial or total lung collapse

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16
Q

Simple pneumothorax assessment findings

A

Pleuritic chest pain
Tachypnea refractory to treatment
Decreased or absent lung sounds on affected side

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17
Q

Simple pneumothorax management

A

Position of comfort
High flow O2
PPV may hasten progression to a tensionpneumo

18
Q

Characteristics of an open pneumothorax

A

Penetrating trauma

19
Q

Open pneumothorax assessment may include

A

Sucking chest
Absence of lung sounds unaffected side
Hypotension

20
Q

Management of an open pneumothorax

A

High Flow 02
Caution with PPV
Occlusive dressing applied
Close of dressing may need to be burped to manage tension pneumothorax

21
Q

Characteristics of a tension pneumothorax

A

Unilateral Lung Collapse
Mediastinum shift
Preload decreases
Cardiac output decreases

22
Q

Signs and symptoms of a tension pneumothorax

A 
Unilateral absent breast sounds
An equal chest rise
Hypotension
Sub Q emphysema
JVD
Tracheal deviation
23
Q

Management of a tension pneumothorax

A

Burp occlusive dressing
Insert large bore IV catheter midclavicular into second intercostal space just above third rib or midaxillary into 4th or 5th intercostal space.
Advance needle until bottles or airbrush is seen then advanced catheter to the hub
May need repeated treatment

24
Q

Characteristics of a hemothorax

A

Pleuritic space can potentially hold 2.5 to 3 L of blood

May progress to tension hemothorax

25
Q

Signs and symptoms of a hemothorax

A

Tachypnea
Decreased breath sounds
Symptoms related to hypovolemia

26
Q

Management of a hemothorax

A

Hi Flo 02
Intubation as needed
IV fluids
Permissive hypotension

27
Q

Characteristics of a pulmonary contusion

A

Causes interstitial and alveolar bleeding
Sections of alveoli no longer ventilate or perfuse
Patient does not tolerate fluid overload

28
Q

Characteristics of cardiac Tamponade

A

Fluid fills the myocardial sack reducing preload and cardiac output

29
Q

Cardiac Tamponade management

A

Beck’s Triad - JVD, muffled heart tones, narrowing pulse pressure
02
Transport
Pericardiocentesis
Large bore IV and fluid as needed for hypotension

30
Q

Cardiac contusion on assessment

A 
May present similar to MI
EKG abnormalities
Heart palpitations
Tachycardia out of proportion to condition
Hypotension
31
Q

Cardiac contusion management

A 
Oxygen
Transport
EKG
Treat dysrhythmias per ACLS
No ASA
No Nitro
32
Q

Characteristics of diaphragmatic rupture

A

High-pressure compression to abdomen
Colon, small intestine, stomach, spleen forced into chest cavity
Restricted lung expansion

33
Q

Signs and symptoms of diaphragmatic rupture

A

Abdominal pain
SOB
Decreased BS

34
Q

Management of a diaphragmatic rupture

A 
PPV
Do not use MA
ST pants
Rapid transport
Oxygen
Intubation PRN
35
Q

Characteristics of an aortic rupture

A

Typically a deceleration injury
Common in MVA
80-90% fatality in 1st hour

36
Q

Assessment findings for an aortic rupture

A

Pulse quality difference between right and left arms and or between upper and lower extremities
Severe and rapidly progressing hypotension

37
Q

Treatment for an aortic rupture

A

Transport
Oxygen
IV fluids

38
Q

Characteristics of a tracheal/ bronchial rupture

A

Tear allows rapid airflow into pleural space

Produces tension pneumonia refractory to decompression

39
Q

Tracheal/ bronchial rupture assessment findings

A

Severe dyspnea
Hemoptysis
Massive sub Q emphysema
Hypotension

40
Q

Tracheobronchial rupture management

A

Use caution with positive pressure ventilation, it may worsen the condition
Allow patient to breathe on their own with 100% hi Flo 02
Rapid transport

41
Q

Characteristics findings for traumatic asphyxia

A

Reddish purple discoloration of the face and chest
JVD
Swelling of conjunctiva
Caused by blood being forced from the right side of the heart into veins of the upper thorax, neck and face

CH 35 Chest Trauma (1 decks)

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