Pfeiffer - Throacic Trauma Flashcards
Ribs
Always go OVER, never go UNDER (neurovascular bundle here)
Mechanism of thoracic injury
- Blunt (direct or deceleration)
2. Penetrating - (considered intraabdominal if under rib 4-5/the nipple)
Blunt mechanism of injury: 2 types
- Direct
- Deceleration forces
What type of injury happens to solid organs with blunt force?
Fracture
What type of injury happens to holloworgans with blunt force?
Blowout
s/s of thoracic trauma
- SubQ emphysema (retroperitoneal air dissection- scrotums or vulva)
Deadly dozen thoracic trauma
**primary
Airway obstruction
**Flail chest
**Open pneumothorax
**Massive hemothorax
**Tension pneumothorax
**Cardiac tamponade
Myocardial contusion
Traumatic aortic rupture
Tracheal or bronchial tree injury
Diaphragmatic tears
Pulmonary contusion
Blast injuries
Airway obstruction - what does it cause?
secondary hypoxia
- ALWAYS assume cervical spine injury
Flail chest
2 or more contiguous ribs broken in 2+ places
INSPIRATION:
- causes lung volume decrease upon inspiration (neg. pressure)
- mediastinum moves across, compromising the other lobe
- mediatstinum shift torques the vena cava
Opposite upon EXPIRATION.
Immediate/field tx for flail chest
External support
Monitor for flail chest for…
Pulmonary contusion
Hemothorax
Pneumothorax
Sucking chest wound is what?
Open Pneumothorax - air enters pelura and ven impaired, hypoxia results
Open pneumothorax tx
Close the hole
If you put an open chest seal, do what?
Make sure it doesn’t clog.»_space; would create tension pneumothorax
Differentiate MASSIVE hemothorax from tension pneumothorax
MASSIVE = DULL TO PERCUSSION!
all fluid, no air
