Pulmonary Contusion

Question 1

Clinical Presentation of Pulmonary Contusion

Answer 1

Dyspnea
Ineffective cough
Hemoptysis
Hypoxia/Hypercarbia
Tachypnea/Tachycardia
Chest pain
Chest wall contusion or abrasions

Question 2

Diagnostics include?

Answer 2

US
CT
CXR

Question 3

How quickly is Pulmonary Contusion visible on CT?

Answer 3

detected on initial imaging

Question 4

How quickly is Pulmonary Contusion visible on CXR?

Answer 4

not evident on initial radiographs 1/3 of the time; takes ~6hrs for opacities to show
Evolve over 24-48hrs

Question 5

What is the diagnostic hallmark of pulmonary contusion on CXR?

Answer 5

irregular, nonlobular opacification of pulmonary parenchyma

Question 6

Management of Pulmonary Contusions includes?

Answer 6

Supportive Care
Prevention
Pain control - epidural
Pulmonary toilet/CPT
PEEP
Euvolemia (judicious use of fluids, resuscitate as necessary with crystalloid or colloid to optimize tissue perfusion)

Question 7

Complication of Pulmonary Contusion includes?

Answer 7

ARDS (60%)
Pneumonia (20%) - due to decreased alveolar secretion clearance