Mod 5 Chest and Abdominal Trauma Flashcards
Flail chest
-Fracture of two or more adjacent ribs in two or more places that allows for free movement of fractured segment
Paradoxical motion
-Movement of ribs in a flail segment that is opposite to the direction of movement of the rest of the chest cavity
Patient care for flail chest
- Perform primary assessment
- Administer O2
- If breathing inadequately assist with ventilation’s
- Some systems allow use of noninvasive positive pressure ventilation.
- Monitor the patient carefully
- Watch respiratory rate and depth
Open chest wound
-Not only is skin broken but chest wall is penetrated for example by a bullet or knife blade
Sucking chest wound
-An open chest wound in which air is sucked into chest cavity.
Signs of sucking chest wound
- Patient has wound in chest
- May or may not be sucking sound associated with open chest wound
- May be gasping for air
Patient care for open chest wound
- Maintain open airway
- Seal the open chest wound as quickly as possible
- Apply occlusive dressing at least 2 inches wider than wound.
- Administer O2
- Care for shock
- Transport as soon as possible
- Consider advanced life support if it will not delay the patients arrival at hospital.
Flutter valve and occlusive dressing
- Sealing plastic on all sides except for one corner
- On inspiration dressing seals wound preventing air entry
- On expiration allows air to escape through untapped section of dressing
Asherman chest seal
-Includes one way valve in the design
Pneumothorax
-Occurs when air enters the chest cavity possibly causing collapse of a lung
Tension pneumothorax
-A type of pneumothorax in which air that enters chest cavity is prevented from escaping
Hemothorax
- When the chest cavity fills with blood
- Can be caused when lacerations within chest cavity are produced by penetrating objects or fractured ribs
Hemopneumothorax
-Chest cavity fills with both blood and air
Traumatic asphyxia
- Associated with sudden compression of the chest.
- Sternum and ribs exert severe pressure on heart and lungs forcing blood out of the right atrium and up into the jugular veins in the neck.
Cardiac Tamponade
-When an injury to the heart causes blood to flow into the the surrounding pericardial sac.
Aortic injury and dissection
- Damage to the aorta the largest artery in the body.
- Damage to the aorta can cause fatal bleeding.
Commotio cordis
-When a patient is hit in the center of the chest causing ventricular fibrillation. Or an uneven pumping of the heart resulting in a cardiac arrest.
Signs of a pneumothorax
- Respiratory difficulty
- Uneven chest wall movement
- Reduction of breath sounds on the affected side of chest
- Increase in respiratory difficulty
- Developing shock, rapid or weak pulse and low blood pressure due to decreased cardiac output
- Distended neck veins
- Tracheal deviation to uninjured side
- Reduced or absent breath sounds on affected side of chest
Signs of a hemothorax
-Signs of a pneumothorax plus coughed up red frothy blood
Signs of traumatic asphyxia
- Distended neck veins
- Head, neck, and shoulders appearing dark blue or purple
- Bloodshot and bulging eyes
- Swollen and blue tongue and lips
- Chest deformity
Signs of a cardiac tamponade
- Distended neck veins
- Very weak pulse
- Low blood pressure
- Steadily decreasing pulse pressure
Signs of aortic injury or dissection
- Tearing chest pain radiating to back
- Differences in pulse or blood pressure between right and left extremities or between arms and legs
- Palpable pulsating mass
- Cardiac arrest
Patient care for injuries to chest cavity
- Maintain an open airway. Be prepared to apply suction
- Administer O2
- Follow local protocols as to the preferred type of dressing for any open wound.
- Care for shock
- Transport as soon as possible
- Consider ALS intercept if it will not delay patients arrival at hospital.
Evisceration and most commonly injured organs
- An intestine or other internal organ protruding through a wound in the abdomen
- The liver and spleen is the most commonly injured organ
What is VIPS
- Vital Signs
- Interventions
- Primary assessment
- Secondary assessment
What is SMOBD
- Sterile
- Moist
- Occlusive
- Bulky
- Dressing
Common signs of abdominal injury
- Pain starting as mild pain then rapidly intolerable
- Cramps
- Nausea
- Weakness
- Thirst
- Obvious lacerations and punctures to abdomen, pelvis, and middle and lower back or chest wounds near diaphragm
- Indications of blunt trauma
- Indications of shock
- Coughing up or vomiting blood
- Rigid or tender abdomen
- Distended abdomen
Abdominal injury care (open and closed)
- Stay alerted for vomiting, keep open airway
- Place patient on back legs flexed
- Administer O2
- Care for shock
- Give nothing by mouth
- Monitor vital signs constantly
- Transport as soon as possible
- Control external bleeding
- Do not touch eviscerated, or exposed organs. Apply SMOBD
- Do not removed any impaled objects.
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