thoracic, abdominal, pelvic injuries (final)

Question 1

2 types of injury with pelvic, thoracic, abdominal injuries?

Answer 1

• soft tissue
• fractures

Question 2

5 general rules for treating someone with pelvic, thoracic, abdominal injuries?

Answer 2

1. pay attention to O2 levels
2. dressing and bandages for external hemorrhaging
3. pay attention to risk factors for internal hemorrhaging
4. limit risk of infection
5. treat for shock.

Question 3

what is a chest thoracic injury?

Answer 3

• a blunt or penetrating force applied to the chest. they can be be wither open or closed.

Question 4

name 6 s/s of general chest injuries?

Answer 4

1. respiratory distress or arrest
2. pain at the site of injury that increases with deep respirations or movement.
3. obvious deformity
4. unequal or paradoxical movement of the chest wall.
5. flush, pale, bluish skin
6. coughing up blood.

Question 5

what is thoracic auscultation?

Answer 5

• when using a stethoscope there may be a decreased or absent breath sound on the injured side.

listen for it just under the clavicle or at the bottom of the armpit.

Question 6

why would a rib # be life threatening?

Answer 6

• if there are multiple fractures, or if there is pain on multiple palpation of the ribs. it is life threatening because if the rib breaks then the sharp edges can cut a artery and the person can bleed out.

Question 7

name 3 reasons why you would suspect a rib fracture?

Answer 7

1. persons respirations are painful, shallow, or laboured.
2. person attempt to learn forward to ease the pain, on the side of the fracture.
3. the person tries to stabilize the fracture by putting pressure on the injured area.

Question 8

care for rib fractures?

Answer 8

• person in a semi fowler position
• support and immobilize the area using soft bulky objects.
• provide respiratory interventions if needed. (O2 or assisted ventilations.

Question 9

what are 3 compilations with rib #?

Answer 9

• flail chest
• hemothorax
• pneuothorax

Question 10

what is a flail chest?

Answer 10

• this is when there are multiple fractures to a section of ribs where that part of the rib cage breaks free.
  paradoxical breathing is feeling the th rib wall is moving equally.
• when the person breaths in the segment of the ribs that are broken will move inwards.

Question 11

how do you treat someone with a flailed chest?

Answer 11

• bulky dressing to the injured area that is 1/2” thick or more, that covers beyond edges of the segment.
• secure with a basket weave of tape until the whole area is covered.
• call 911.
• treat for shock

Question 12

what is a hemothorax?

Answer 12

• bleeding into the pleural space around the lungs. you will not hear a breath on the affected side, the chest will fill with blood and the lung will be unable to expand which will cause the lung to collapse.

Question 13

what are MOI for hemothorax?

Answer 13

• blunt trauma (closed hemothorax)
• penetrating trauma (open hemothorax)
• a lacerated lung ( open hemothorax)
• lacerated blood vessel in the chest.

Question 14

s/s of hemothorax?

Answer 14

• cyanosis
• neck veins flat
  JVD, tracheal deviation
  breath sounds are absent.

Question 15

treatment of hemothorax?

Answer 15

• O2 as needed.
• control blood if penetration
• assisted breath ventilations.
• RTD 911

Question 16

1. what is a open hemothorax?
2. how do you treat someone w/ a open hemothorax?

Answer 16

1. this is a open wound to the chest from a penetration.
2. administer O2 as needed.
   - cover wound with a NON-OCCLUSIVE dressing and secure. this will allow for air flow which is very important, bc if we don’t have air flow then the lung can collapse. this is the only time you can replace dressing once it is fully saturated.
   - assisted ventilation
   - place person in recovery on injured side, so blood and air can drain out.

Question 17

what is a pneumothorax?

Answer 17

• a condition caused by air entering the pleural space around the lungs.
• depending on the amount of air around the lung it can partially or completely collapse.
• if air escapes once into the pleural space it is considered a simple pneumothorax.

Question 18

3 MOI for pneumothorax?

Answer 18

• blunt trauma
• penetration trauma
• spontaneous

Question 19

s/s pneumothorax?

Answer 19

• pleuritic chest pain. (increase pain with coughing or inhaling.
• dyspnea (SOB), tachypnea (rapid breath)
• decreased or absent breath sound on injured side.
• subcutaneous emphysema

Question 20

what is a spontaneous pneumothorax?

Answer 20

• person complains of sudden sharp chest pain and sudden shortness of breath fallowing sternuous exertion, coughing, or air travel.

Question 21

what is tension pneumothorax?

Answer 21

• lung tissue is torn causing a continual flow of air into the pleural space, and a steady increase of pressure. this will eventually cause the lung to collapse.

Question 22

treatment of tension pneumothorax?

Answer 22

• administer O2 as needed.
• patient positioning
• assisted ventilations
  – RTD

Question 22

s/s of tension pneumothorax?

Answer 22

• tachycardia
• hypotension
• • tracheal deviation*
• JVD
• low O2 levels.

Question 23

what is subcutaneous emphysema?

Answer 23

• air becomes trapped in tissues beneath the skin. this is most common with penetrating trauma to the lungs and bronchial tube. affected area appears swollen.

Question 24

general treatment for penatrating chest injuries?

Answer 24

- control internal and external bleeds. - treat respiratory distress and arrest - use non-occluded cause to allow airflow (if you don't have the right gauze then don't do anything.) - RTD.

Question 25

what is commotion cordis?

Answer 25

- disruption of heart rhythm that occurs because of a blow to the area directly over the heart at a heart contraction that leads to cardiac arrest.

Question 26

what is McBurney's point?

Answer 26

- this is the measured 1/3 of the distance from the R ASIS. (appendix)

Question 27

name 5 general s/s of abdominal injuries?

Answer 27

- external bleeding - distention (bloated) in the abdomen. - nausea & vomitting (w/ or w/o blood.) - possible organ protruding - pale, moist skin

Question 28

general care of someone who has a open and closed abdominal injuries?

Answer 28

CLOSED - care for internal bleeding and shock - place in supine w/ knees bent, allowing for muscles of abdomen to relax - O2 as needed. OPEN - general care for external bleeding. - apply trauma dressing and gentle pressure.

Question 29

what is abdominal evisceration?

Answer 29

- when a major open wound occurs in which the abdominal organs protrude through the wound.

Question 30

how do you treat someone with abdominal evisceration?

Answer 30

- remove clothing - place carefully inn supine. -apply warm moist sterile dressing loosely over the injury. - administer O2 as needed. - RTD - leave organs where they are.

Question 31

what is abdominal aortic aneurysm? (AAA)

Answer 31

- the wall of the abdominal aorta weakens and bulges, creating localized enlarged area. as it expands the pain will increase ad vessel walls become thinner and the risk of rupturing increases.

Question 32

how do you treat someone with (AAA) abdominal. aortic aneurysm?

Answer 32

- call 911

Question 33

s/s for (AAA)?

Answer 33

- abdominal pain - abdominal rigidity - diminished or absent femoral or pedal pulses - numbness or tingling in the lower extremities? - pulsating mass in the abdomen.

Question 34

what would cause someone to be more susceptible to a spleen injury?

Answer 34

- when someone gets mono the spleen enlarges dropping it below the rib cage. the infection attacks red and white blood cells and starts to slow down the system.

Question 35

s/s of spleen injury?

Answer 35

- abdominal rigidity (LUQ) - nausea - kehr's sign (pain referred to lower left chest and shoulder area, about 1/3 down left arm.

Question 36

s/s of pelvic injury?

Answer 36

- severe pain - pelvic instability - numbness in legs - paralysis - rectal, urethral or vaginal bleeding.

Question 37

general care of someone with a pelvic injury?

Answer 37

- avoid pressure on the pelvis - minimize movement - treat for shock - call 911 - control external bleeds