thoracic trauma Flashcards
1
Q
why are rib #s important
A
- pain
- associated injuries
- need a lot of force to break a rib (esp 1 and 2)
2
Q
def.flail chest
A
3 ribs #ed in 2 places
- flee floating segment
3
Q
3 problems with flail chest
A
- pain
- paradoxical breathing
- injury to underlying lung
4
Q
4 treatments of flail chest
A
- pain mgmt
- o2
- intubation and mech vent
- surgical stabilization of ribs
5
Q
what are pulm contusions
A
- bruising of lungs
- appear within 6 hours and evolve over time
- worsen with fluids
- may dev. ARDS if severe
6
Q
2 ways to define pneumothorax
A
- closed vs. open
2. simple, tension, occult
7
Q
def. closed
A
no connection from outside
- air in from lung
8
Q
def. open
A
hole in chest wall and parietal pleura
- if ball valve, can get trapped and cause tension
9
Q
def. simple
A
no effect on BP or mediastinum
10
Q
def. tension
A
air in pleural space, can’t escape
- incr intrathoracic pressure
- less venous return
- lower BP
11
Q
4 signs of TPNX
A
- hypotension
- decreased air entry on that side
- tracehea deviation to other side
- eleveated JVP
12
Q
def. occult pneumo
A
not visible on CXR - only CT
- 25% go on to tension
13
Q
2 treatment for pneumo
A
- o2
- drain air from pleural space
- simple - chest tube
- tension - needle decompression (2nd ICS, above rib)
- follow with tube
14
Q
6 locations of bleeding in hemothorax and pressure
A
- lung - low
- pulm vessels - low
- intercostal A - arterial
- internal mammary - arterial
- Aorta -
- abdo - rare
15
Q
3 indications for thoracotomy in hemothorax
A
- > 1500cc initial drainage
- > 250cc/hr x 4 hr
- retained hemothorax
