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AET 261: Emergency Conditions 2 > Thoracic, Abdominal & Pelvic Injuries > Flashcards

Thoracic, Abdominal & Pelvic Injuries Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What are 5 general rules when dealing with torso injuries?

A
  1. Monitor supplemental O2 requirements
  2. Apply dressings and bandages for external hemorrhages
  3. Monitor risk factors for internal hemorrhages
  4. Limit risk of infection
  5. Treat for shock
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2
Q

What are the main MOI’s for a chest injury, and what categories do they fall into?

A

Blunt force trauma or penetrating forces applied to chest.

Categorized as open or closed.

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3
Q

S/S of general chest injuries

A
  1. Respiratory distress/arrest
  2. Pain at injury site that increases with movement or deep inspirations
  3. Obvious deformity
  4. Paradoxical movement of chest wall
  5. Flushed, pale or blue skin
  6. Coughing up blood
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4
Q

T/F: Should all chest injuries be considered a RTD?

A

True, until proven otherwise.

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5
Q

When assessing the thorax, what are the locations of auscultation? What will it sound like?

A

Auscultate upper anterior chest above clavicle and lateral chest, on nipple line under axilla.

Sounds will be totally absent, or crackling, wheezing or congestion.

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6
Q

If someone is concerned about a potential broken rib or ribs, how would you confirm the amount of ribs damaged?

A

Palpation.

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7
Q

When should you suspect a rib fracture(s)?

A
  1. Patient resp. presets as painful/shallow or laboured.
  2. Patient attempts to ease pain by leaning to toward site of potential #
  3. Patient attempts to stabilize via pressure on injured area
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8
Q

What 3 steps should be taken to care for a rib fracture?

A
  1. Place patient in Semi-Fowlers position
  2. Support & immobilize the area with a bulky soft object (towel or pillow)
  3. Provide resp. interventions if necessary
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9
Q

What is a Flail chest?

A

When multiple ribs are fractured, creating a complete separation of the rib cage from surrounding tissues that does not translate normally during respiration.

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10
Q

What is Paradoxical breathing?

A

Deflation of the lung during inspiration and inflation of the lung during expiration.

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11
Q

After performing a focused exam on the ribs, you determine the patient has a flail chest injury, how would you stabilize the area?

A

By applying a bulky dressing that has the following qualities:
1. Minimum half inch thick
2. Extends beyond all sides of the flailed segment
3. Secured in place with basket-weave-style tape.

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12
Q

What is a Hemothorax? What are the associated MOI?

A

Bleeding into the Pleural space surrounding the affected lung. As the cavity fills, the pressure around the lung increases, making it increasingly more difficult for the lung to expand. Rapidly leads to respiratory failure.

Blunt force or penetrating trauma to the chest.

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13
Q

What S/S will a patient present with for a Hemothorax?

A
  1. Cyanotic skin
  2. Dyspnea (shortness of breath)
  3. NO JVD present
  4. Symptoms of shock
  5. Absent, or dull sounds of breathing
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14
Q

What is a Pneumothorax? What are the associated MOI?

A

A condition caused my air entering the pleural space around the lung potentially resulting in a partially or fully collapsed lung.

Possible MOI include: blunt trauma, penetrating trauma or could be spontaneous.

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15
Q

What is a Simple Pneumothorax?

A

A one-time escape of air into the pleural space.

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16
Q

What are the S/S of a Pneumothorax?

A
  1. Pleuritic chest pain
  2. Dyspnea/Tachypnea
  3. Dulled or absent breathing sounds on affected side
  4. Subcutaneous emphysema
17
Q

What can a simple pneumothorax progress into?

A

A Tension/complex pneumothorax.
This is a result of torn lung tissue causing a continuous flow of air and gradual increase in pressure in the pleural space, eventually leading to lung collapse.

18
Q

What are the S/S of a complex Pneumothorax?

A
  1. Tachycardia
  2. Hypotension
  3. Tracheal Deviation
  4. Jugular Vein Distention
  5. Signs of hypoxia
19
Q

What is Subcutaneous Emphysema?

A

A rare condition that usually only occurs with penetrating trauma to the chest/bronchial tube.

Air becomes trapped in the tissues beneath the skin, which produces a crackling sensation when palpated.

20
Q

Regarding general treatment of penetrating chest wounds, what is the most important thing to consider?

A

When applying dressings to the open wound, not to let it become occluded. Air needs to continue to pass through the wound. This is the only situation in which changing saturated bandages is acceptable.

21
Q

What is Commotio Cordis?

A

A lethal disruption of the heart rhythm that occurs with direct blunt trauma directly over the heart at the beginning of the T-wave that causes Cardiac arrest.

22
Q

Where is McBurney’s Point?

A

Measured approximately 1/3 the distance from the R ASIS to the Umbilicus.

23
Q

What is Rebound Pain and what is it often associated with?

A

Pain that is relieved when pressure is applied and when the pressure is removed, causes the pain to return.

Often associated with an appendix rupture around McBurney’s point

24
Q

General S/S of abdominal injuries

A
  1. Severe pain
  2. Bruising
  3. External bleeding
  4. Nausea / vommitting
  5. Pale / moist skin
  6. Thirst
  7. Tenderness/tightness in abdomen
  8. Abdominal distention
  9. Possible organ protrusion
  10. S/S of shock
25
Q

General care for abdominal injuries

A

When the wound is closed:
- Care for internal bleeding and shock
- Flex knees to 90 degrees or comfortability so allow relaxation of abdominal muscles

When wound is open:
- Care for external bleeding via gentle pressure and trauma dressings

26
Q

What is the best course of action for treating an abdominal evisceration?

A
  • Carefully place into supine position
  • Avoid direct pressure
  • DO NOT attempt to reinsert organs into abdomen
  • Apply warm, moist and sterile dressings loosely over injury site
  • Cover entirety of injury and dressings with loose occlusive covering (plastic wrap)
  • Flex & support knees to reduce tension on abdominal wall
  • Treat for shock
  • RTD
27
Q

What is an AAA?

A

An Abdominal Aortic Aneurysm occurs when the wall of the abdominal aorta weakens and bulges, creating a localized enlarged area. As it progresses the wall thins, becomes painful and risk of rupture increases. Will have a pulsating mass in abdomen.

28
Q

When an MOI indicates a kidney injury, what is the number one thing to educate the athlete about?

A

Hematuria. Because blood in the urine won’t usually occur immediately, informing the athlete to monitor their urine for blood over the next 24 hours is essential.

29
Q

If a player has Mononucleosis, why would they not be cleared to play?

A

Mono causes the spleen to swell and distend beneath the protection of the ribs, making it more susceptible to injury. If the spleen is struck with enough force in this position, it can rupture.

30
Q

Inside the femoral triangle, what structures exist, and in what order?

A

Medial to lateral: VAN
Femoral Vein
Femoral Artery
Femoral Nerve

31
Q

What are the common S/S of a pelvic injury?

A
  • Any S/S of an abdominal injury
  • Severe pain
  • Pelvic instability
  • Crepitus
  • Numbness in legs
  • Paralysis
  • Rectal, urethral or vaginal bleeding
32
Q

What are the main rules for caring for a pelvic injury?

A
  • Prioritize minimizing movement
  • Control external bleeding
  • Treat for shock
  • Avoid pressure on pelvis
  • Assist with pelvic binding if avail.
  • RTD
33
Q

What are the main S/S of a bladder injury?

A

Very similar to kidney damage:
- Feeling of need to urinate, but can’t
- Monitor for hematuria over the next 48 hours as symptoms take time to produce

34
Q

What are the S/S of a scrotal contusion?

A
  • Severe pain
  • Disabling
  • Possible hemorrhaging
  • Swelling
  • Muscular spasm
  • Nausea/vomiting
  • Shock
35
Q

How would you care for someone with a scrotal contusion?

A
  • Keep athlete supine, with knees FLEXED (or in most comfortable position)
  • Be aware of a possible pelvic fracture
  • Encourage short breaths to manage pain
  • Apply COLD, do NOT APPLY HEAT
  • Ask athlete to check that both testes are in normal place
  • Cover any open wounds with sterile dressings

AET 261: Emergency Conditions 2 (11 decks)

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