Thoracic Injuries Flashcards
What can thoracic injuries result from?
Penetrating and blunt mechanisms
Blunt thoracic trauma can include?
Direct compression
-fracture of solid organs
-blowout of hollow organs
Deceleration forces
-shearing of organs and blood vessels
Penetrating trauma
-direct trauma to organ and vasculature
Energy transmitted from mass and velocity
What can compromised ventilation and oxygen exchange lead to in thoracic trauma?
Inadequate oxygen delivery
Hypovolemia from blood loss
Ventilation/ perfusion mismatch
Pleural pressure changes
Pump failure
Signs and symptoms of thoracic trauma
SOB
Chets pain
Hemoptysis
Cyanosis
Distended neck veins
Tracheal deviation
Asymmetrical chest rise (flail chest)
Chest wall contusion
Open wounds
Subcutaneous emphysema
TIC
Abnormal breath sounds
What is the deadly dozen?
- Airway obstruction
- Flail chest
- Open pneumothorax
- Tension pneumothorax
- Massive hemothorax
- Cardiac tamponade
- Myocardial contusion
- Traumatic aortic rupture
- Tracheal or bronchial tree injury
- diaphragmatic tears
- Pulmonary contusion
- Blast injuries
What is the management of flail chest?
Ensure open airway
Ventilate
High flow O2
Load and go
Consider peep
Monitor for shock
What is an open pneumothorax? How do you manage it?
A sucking chest wound
-air enters the pleural space
-Ventilation is impaired
-hypoxia results
Manage by closing the chest wall with an occlusive dressing, oxygenate and ventilate
Load and go
Signs and symptoms of tension pneumothorax
Dyspnea
Anxiety
Tachypnea
DVT
Tracheal deviation
Diminished breath sounds (HYPERressonance)
Shock with hypotension
How would you mange tension pneumothorax?
Ensure Open airway
High flow oxygen
Lad and go
Signs and symptoms of massive hemothorax?
Anxiety and confusion
Flat neck veins (indicates hypovolemia)
Breath sounds decrease (dull percussion)
Shock
How would you manage a patient with Massive hemothorax?
Secure. Open airway
High flow oxygen
Load and go
Treat fro shock (I’ve fluid en route)
Monitor for tension hemothorax
What is becks triad for ?
Cardiac tamponade
What does beck triad consist of?
Hypotension
Distended neck veins
Muffled heart sounds
How would you manage a patient with cardiac tamponade?
Ensure open airway
High flow oxygen
Load and go
Treat for shock
Fluid administration
Monitor and treat tachydysrythmias
Monitor for hemothorax and pneumothorax
What is the most common cardiac injury and h ow does it present
Myocardial contusion
Presents with chest pain
dysrhytmias
Mor rare but cardiogenic shock
How would you mange a patient with a myocardial contusion
Ensure open airway
High flow oxygen
Load and go
Monitor 12 lead
Teat for shock
Treat dysrhytmias
Watch for complications
How does traumatic aortic rupture affect the blood. Pressure in the arms and legs?
Blood pressure will be HYPERtension In upper extremities and HYPOtension in lower extremities
What is a diaphragmatic tear? How will the patient present?
Severe blow to abdomen
Herniation of abdominal organs
More. Common on the. Left side
Patient will have dismissed breath sounds, abdomen appears scaphoid
Bowel sound scan be auscultated in the chest
How does a blast injury occur? What can it cause? How do to treat t?
Air over pressure blast affecting the lungs
-pneumothorax, tension pneumothorax, pulmonary contusions
There. Can be penetrating. Trauma form debris
Treat with high flow oxygen, load and go, manage injuries found
What does traumatic asphyxia result in?
Ruptured capillaries
Cyanotic above the compression
Swelling of the head, neck, tongue and lips
Conjunctivital hemorrhage
How will a patient with a simple pneumothorax present?
Fractured ribs
Pleuritic chest pain
Dyspnea
Decreased. Breath sounds
Tympany upon percussion
