RESPIRATION AND CHEST TRAUMA Flashcards
Blood vessels of the chest
(a)Great vessels
(b)Pulmonary arteries
(c)Intercostal vessels
(d)Internal Mammary artery
The ______ of the chest is where the trachea, pulmonary arteries and pulmonary veins are located.
hilum
What is Lethal disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart at a critical time during the cycle of the heartbeat causing cardiac arrest
Commotio Cordis
What are the 3 types of pneumothorax
(a)Simple
(b)Open: also called “sucking chest wound”
(c)Tension
What issue?
Assessment:
Demonstrates findings similar to those in rib fracture:
1)Chest pain
2)Dyspnea
3)Tachycardia
4)Decreased breath sounds on affected side
5)Wound may make audible sucking sounds during inspiration
Simple Pneumothorax
Simple Pneumothorax Management
1) Monitor casualty closely for development of tension pneumothorax and the need for decompression.
2) Administer supplemental oxygen.
3) Obtain IV access.
4) Be prepared to treat shock if it develops.
5) Rapid transport is essential if functioning at a basic Level 1.
6) If MEDEVAC by air you must either perform needle decompression or place a chest tube so that it does not become a tension pneumothorax in the air.
What issue?
Assessment:
Generally, reveals obvious respiratory distress.
(1 Dyspnea
(2 Sudden sharp pain
(3 Subcutaneous Emphysema
(4 Decreased lung sounds on affected side
(5 Red Bubbles on Exhalation from wound (aka “Sucking ChestWound”)
Open Pneumo
Open Pneumothorax Management
1) Initial management of an open pneumothorax involves closing the defect in the chest wall and administering supplemental oxygen.
-Occlusive dressing
-ETI if occlusive dressing fails (positive pressure)
2) If signs of increasing respiratory distress, remove dressing to allow decompression
3) if ineffective needle decompression or chest tube and positive- pressure ventilation should be considered
Casualty with an open pneumothorax virtually always has an injury to what?
Underlying lung
what is The introduction of a needle or catheter into the pleural space to releasetrapped/accumulated air within the pleural space.
Needle Thoracentesis
In casualties with increasing intra-thoracic pressure from a developing tension pneumothorax, the side of the thoracic cavity that has the increased pressure should be ______
Decompressed
Needle decompression should be performed when what three criteria are met?
(a) Evidence of worsening respiratory distress or difficulty with BVM device.
(b) Decrease or absent breath sounds
(c) Decompensated shock (SBP <90mm Hg)
Small vs large Pneumo
(a) Mild to moderate increase in respiratory rate
(b) Mild to moderate tachycardia
(c) Diminished breath sounds on affected side
Small
Small vs large Pneumo
(a) Tachypnea – marked
(b) Tachycardia – marked
(c) Cyanosis
(d) Absent breath sounds on affected side
(e) Subcutaneous emphysema-released air becomes trapped within the subcutaneous tissue. Feels like “rice crispies” underneath the skin.
(f) Decreasing level of consciousness
Large
Some complications associated with a needle thoracentesis are:
(a) Hemothorax
(b) Bacterial infection
(c) Air embolism
