Paediatric Chest Injury

Question 1

What 3 things do all peadiatric patients with chest injury get?

Answer 1

1. Position sitting upright if possible
2. Oxygen
3. Pain relief

Question 2

What are 3 signs of a pneumothorax?

Answer 2

1. Unequal breath sounds
2. Subcutaneous emphysema
3. SpO2 <92% on room air

Question 3

What do you need to do if you suspect a pneumothorax

Answer 3

• Monitor closely for deterioration

Question 4

What are 5 signs a patient may have a tension pneumothorax?

Answer 4

1. Inadequate perfusion
2. Increasing repsiratory distress
3. SpO2 < 92% despite oxygen
4. Increased peak inspiratory pressure/stiff bag
5. Decreased ETCO2

Question 5

What are the 3 care objective of paediatric chest injury

Answer 5

1. Adequate oxygenation
2. Effective pain relief to assist in maintaining adequate ventilation
3. Early identification and management of tension pneumothorax

Question 6

What is the pathophysiology of a tension pneumothorax

Answer 6

1. Damage to lung tissues and pleural space
2. Creates 1 way valve where air can enter but cant escape
3. Volume of air in pleural space increases
4. Increased pressure collapses ipsilateral lung
5. mediastinal shift away from affected side
6. Compresses superior and/or inferior vena cave
7. Decreased blood return to right atrium
8. Blood backs up in venous system
9. reduced cardiac output
10. Tachycardia and hypotension
11. Obstructive shock
12. Coma
13. Death