Penetrating Chest Trauma

Question 1

Penetrating Chest Trauma

ASAP:

Answer 1

ABCs, 2 LB IVs, O2, monitor, VS, C-collar,   RSI/ETT (if no PTX), full primary survey

Question 2

Penetrating Chest Trauma

Hx / Exam:

Answer 2

mxm of injury, SAMPLE hx, trachea ML, BS/symmetry, WOB, JVD, heart sounds, ext bleeding, entrance/exit wounds,FAST,
pulses, GCS/gross neuro, pelvis, rectal/log roll, subQ emphysema; full secondary survey, serial FASTs and echos

Question 3

Penetrating Chest Trauma

Labs:

Answer 3

CBC, BMP, LFT, coags, EtOH, T&C, UA, hCG,   ABG

Question 4

Penetrating Chest Trauma

Rads:

Answer 4

CXR, CT chest/abd (if stable)

Question 5

Penetrating Chest Trauma

Tx if airway compromised:

Answer 5

Intubate

Question 6

Penetrating Chest Trauma

Treatment if tension PTX:

If tension PTX…

Answer 6

Needle decompression

Question 7

Penetrating Chest Trauma

Treatment if hemo/PTX:

Answer 7

Chest tube

Question 8

Penetrating Chest Trauma

Treatment If initial CT output > 1500 ml or > 200 ml/ hr x 6hr:

Answer 8

→ OR!

Question 9

Penetrating Chest Trauma

Treatment if VS unstable:

Answer 9

O-neg or typed PRBCs (or autotransfuse)

Question 10

Penetrating Chest Trauma

Treatment if tamponade:

Answer 10

Pericardiocentesis

Question 11

Penetrating Chest Trauma

Treatment If penetrating chest trauma w loss of VS w/ EMS or in ER :

.

Answer 11

Thoracotomy!

Question 12

Penetrating Chest Trauma

TreatmentIf hemopericardium w/ VS or severe tracheobronchial tree injury:

Answer 12

→ OR!