Thoracic Trauma Flashcards
Initial approach to thoracic trauma
stabilise and treat shock
common problems
- thoracic wall
- intrathoracic
-diaphragmatic rupture
- pneumothorax
- pulmonary contusion
Investigations upon suspicion of thoracic trauma
- haematology
- biochem
- thoracocentesis
- urine output
- radiography
- US
sternal fracture/dislocation
- found on x ray
- no pain so no treatment is required
fractured ribs
- found on x ray
- extremely painful
- give painkillers and ABs
- don’t need to strap etc and adjacent ribs will act as support
Why would you give ABs with a fractured rib?
build up of bronchial secretions in lungs due to animal shallow breathing because of the pain makes them predisposed to pneumonia
Flail chest
- a unit of ribs have 2 fractures making the unit unstable
- compromised breathing
Treatment of a flail chest
- ABs and painkillers
- stabilise with lolllypop stick and zimmer plants, suture round rib and bandage in place
Different types of pneumothorax
simple: defect in lung/small bronchi and air leaks into pleural cavity
tension: air moves into pleural cavity but doesn’t move out again: air in cavity increases with each breath and increasingly compresses the lung
mediastinal: defect higher up in lungs so air leaks into thorax and mediastinum
Treatment options for a pneumothorax
- cage rest
- single tap (if excessively dyspnoeic)
- place drain (if reoccurrence after single tap)
CS of a pneumothorax on x ray
- elevated heart
- dark peripherally
- bright lungs
CS of a tension pneumothorax
- sharp, shallow breaths
- flat, concave and caudal diaphragm on x ray
Pulmonary contusion
- CS
- association
- treatment
- very white lungs on xray
- often seen with a pneumothorax
- mixture of blood and oedema
- give ABs and painkillers
Pneumomediastinum
- association
- CS
- treatment
commonly seen with a pneumothorax
“puffy dog”
no specific treatment
Diaphragmatic rupture clinical signs
- tachypnoea/dyspnoea
- muffled heart sounds
- displaced heart sounds
- borborygmi
- empty abdomen
