Life Threatening Chest Injuries

Question 1

What is ATOMFC?

Answer 1

Abbreviation of life threatening chest injuries

Airway Injury
Tension penumo
Open pneumo
Massive haemothorax
Flail chest
Cardiac tamponade

Question 2

What is open pneumo?

Answer 2

Air accumulates between lung and chest wall due to wound on chest
Will be bubbling at site of chest
Tension pneumo can develop

Management

• asherman valve= one way valve that lets air out but not in
• Chest drain not near wound
• surgical closure

Question 3

What is a massive haemothorax?

Answer 3

Blood accumulating in pleural space
Often due to rib fracture causing venous injury
Signs of shock, dull percussion and no breath sounds

Management

• large bore cannula in 6th ICS mid clavicular
• if draining >200mls continuously for 4hrs then thoracotomy

Question 4

What is flail chest?

Answer 4

At least 2 rib fractures with at least 2 breaks per rib causing a mobile segment of the rib cage
Causes severe pain on inspiration
Due to blunt force trauma
Resp failure
Require intercostal block or anaesthesia
May need mechanical ventilation

Question 5

What is cardiac tamponade?

Answer 5

Blood accumulating in pericardial cavity
Often due to wound penetrating pericardium e.g. stabbing

Raised JVP, low systolic BP and muffled heart sounds

Immediate pericardiocentesis to relieve pressure
Definitive management with thoracotomy