Pulmonary transplants - traumatic causes Flashcards
How prevelant is thromatic trauma?
Accounts for 35% of trauma-related deaths in the U.S
How often is blunt trauma?
most common MVA accounting for 80% of injuries
- 2nd most common in falls
How often is penetrating trauma?
most common in gunshot or stabbing
- accounts for 20% of all major trauma in the U.S
What is assessed for advanced trauma life support?
- assess airway if need for intubation
- assess breathing
- assess circulations
hypotension increases suspicion for pneumothorax
When assessing breathing, what are we looking for?
looking at the trachea if its deviated
chest wall asymmetry
auscultate breath sounds
palpate for frail segments
Respiratory compromise occurs with what?
With common injuries seen such as lung contusion, rib fractures and frail chest
What are the sx of a rib fracture?
breathe shallow
decreased chest wall excusion
decreased lung expansion
How prevalent is a frail chest?
happens in ~7% of chest traumas
What is the cause of a frail chest?
Free-floating segment of the ribs because multiple rib fractures with a clinical diagnosis
What is the clinical diagnosis of rib fractures causing frail chest?
3 or more ribs broken in 2 or more places
What is the cause of pain with a frail chest?
Pain because of the splinting
- continuity of the chest wall is disrupted = paradoxical motion of breathing
- injured segments reverse and move opposite to remainder of the rib cage
What is the timeline of contusions following an injury?
Can progress in the first 12-24 hrs post injury
Pain with contusions is due to?
The splinting and shallow breathing
decreased volumes increase the risk for atelectasis
Where is most rib fractures most common?
in ribs 5-9 because they are less protected that the first 4
What type of fractures cause more pain?
non-displaced fractures = pain and restrictions
Rib fractures cause breathing to be?
Very shallow to prevent the thorax from expanding
- compensation is seen to create muscular splinting, protecting area of injury and reducing expansion
What is commonly seen with fractures?
Hemothorax that can progress to large effusion or empyma
What can also lead to permanent restrictive dysfunction?
Fluid compressing lung parenchyma -> fibrosis/scarring
What is the pain progression for rib fractures?
Coughing may last up to 6 months but overall improvements and mobility happens around 2 weeks post-injury
What is a pneumothorax?
air or gas in the pleural space = collapsed lung tissue
What is classic sign of pneumothorax?
tracheal deviation AWAY from the affected side
- decreased or absent breath sounds
Tension pneumothorax is presumed with what?
chest trauma
respiratory distress
hypotensive
What is hemothorax?
- When only one side is affected
- when blood builds up in the pleural space
What are the sx of pneumothorax?
unilateral pain in the chest
dyspneea
tachycardia
