Thorasic Injury

Question 1

S/S of tension pneumothorax

Answer 1

Chest pain, respiratory distress, tachycardia, hypotension, tracheal deviation, absent breath sounds, JVD

Question 2

Tension pneumothorax treatment

Answer 2

Immediate decompression at the 2nd ICS, midclavicular line, needs a chest tube afterwards

Question 3

Pneumothorax management

Answer 3

Closed thoracostomy

Question 4

Open pneumothorax treatment

Answer 4

Avoid occlusive dressing
Thoracostomy
Surgery

Question 5

Massive Hemothorax treatment

Answer 5

> 1500mls in chest cavity
Fluid resuscitation and blood products
Thoracostomy
Surgery for extensive output

Question 6

Causes and s/s of cardiac tamponade

Answer 6

Causes: penetrating injury
S/S: JVD, tachycardia, muffled heart tones

Question 7

Diagnosis and treatment of cardiac tamponade

Answer 7

Diagnosis: Stat echo
Tx: pericardiocentesis

Question 8

Flail chest s/s and tx

Answer 8

S/s: >2 fractured ribs, paradoxical chest wall movement
TX: adequate ventilation and lung expansion requiring intubation

Question 9

Pulmonary contusion s/s and Tx

Answer 9

S/s: manifest in 24 hours includes hemoptysis
Tx: pulmonary toileting and mechanical ventilation

Question 10

Indications for a resuscitative Thoracostomy

Answer 10

Penetrating thoracic trauma
Arrest
Abdominal trauma: hemorrhage control

Question 11

Goals of a resuscitative Thoracotomy

Answer 11

Control intrathroasic hemorrhage
Relieve cardiac tamponade
Cross clamp thorasic aorta
Restore cardiac output