Mod D Tech 7 Chest Injuries Flashcards
Thoracic Trauma Types
There are two types of Chest injuries :– Open Closed May be Penetrating or Blunt, all can be life threatening
Signs and Symptoms
Dyspnoea Panic
Anxiety Cyanosis
Pain normally at site of injury
Tachycardia
Tachypnoea
Asymmetry of chest wall
General management Assess the chest and neck for
Tracheal deviation
Wounds, bruising or swelling
Emphysema (surgical / subcutaneous) – (can cause swelling to
Laryngeal crepitus chest wall, neck & face)
Venous engorgement
Excluding open/tension pneumothorax, flail segment, massive haemothorax
General Management
Catastrophic Bleeding, Airway, Breathing, Circulation, Disability Administer a high concentration of oxygen (all trauma pt’s benefit from high flow Oxygen) Consider assisted ventilations (<10 or >30?) Seal any wounds Position patient – how? Percussion and Auscultation of Chest Rapid smooth transport to hospital Pre alert
Thoracic trauma‘The Deadly Dozen’
Rib fractures/ flail chest/ Pulmonary contusion
Pneumothorax/ Tension/ Haemothorax
Myocardial contusion/ Tamponade
Ruptured Aorta/ Diaphragm/Trachea
Traumatic Asphyxiation.
Management of Flail Chest
Ensure adequate airway
100% oxygen
Load & Go
Do not stabilize flail segment (Maintenance of ventilation is priority)
Monitor ECG
Alert Hospital
Management of open pneumothorax
Ensure adequate airway
100% oxygen
Seal open wound Load & Go
ATMIST Hospital
Spontaneous Pneumothorax
More common in young men (Tall, thin, late teens) Air leaks from a spontaneous rupture of an alveolus/ alveoli Air slowly builds in the pleural cavity
Tension Pneumothorax
sign and symptoms
Management of Tension Pneumothorax
Ensure adequate airway and ventilation
100% oxygen
Paramedic Assistance - Needle decompression
Load & Go
ATMIST Pre-alert Hospital
Massive Haemothorax
Management of haemothorax
Ensure adequate airway and ventilation
100% oxygen Load & Go
Paramedic interventions
ATMIST pre-alert hospital
Observe for development of Tension Haemopneumothorax
Myocardial contusion causes
Cardiac tamponade Blood leaks into pericardial sac; pressure builds and prevents the heart from refilling to pump blood into circulation.
Beck’s Triad (assoc. with Cardiac Tamponade)
Hypotension
Jugular Vein Distension
Muffled Heart Sounds
Management of Cardiac Tamponade
Ensure adequate airway &; ventilation
100% oxygen
Load &
Go Monitor ECG
ATMIST pre-alert hospital
Traumatic Asphyxiation
Traumatic asphyxia, or Perte’s syndrome, is a medical emergency caused by an intense compression of the thoracic cavity, causing venous back-flow
Pulmonary contusion
Blunt or Penetrating Trauma Capillary bleeding Reduced diffusion of O2 in the alveoli Respiratory Failure can develop within the first 8 – 24 hours Associated with flail chest.
Management of impaled objects
Ensure adequate airway & ventilation
100% oxygen
Stabilize object Do not remove!
Load & Go -
ATMIST
Watch for development of tension pneumothorax or haemothorax
Management of Thoracic trauma -Recap
Dangers / Mechanism of Injury / C Spine ?? Catastrophic bleeding Airway & Breathing Assessment (look / listen / feel) O2 therapy (high %) Consider Paramedic intervention e.g. chest decompression if appropriate Adequate ventilation (<10, >30bpm) Circulation, stop major bleeding & assess systolic BP Time critical, remove patient to hospital Monitor O2 / ECG / GCS / changes in condition ATMIST pre-alert to relay information to receiving hospital.
