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Z - AET 261 > Thorax, abdomen, and pelvic Injuries > Flashcards

Thorax, abdomen, and pelvic Injuries Flashcards

1
Q

General rules for Thorax, abdomen and pelvic injuries

A
  1. pay attendion to supplemental o2 requirement
  2. dressing and bandages for ext. hem.
  3. risk factorss for internal hem,
  4. limited the risk for infections
  5. treat for shock
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2
Q

Signs and Symptoms of general chest injuries

A
  1. Resp. distress or arrest
  2. increase pain at site with respiration/movement
  3. Obvious deformity
  4. unequal or paradoxical movement at chest wall
  5. Flushed, pale, or bluish skin
  6. Coughing up blood
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3
Q

Thoracic injuries

A

Contains the lungs + heart
Most common = rib fracture

MOI: Direct blow or Indirect blow

All chest injuries should be considered LT until proven otherwise

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4
Q

Thoracic Auscultation

A
  • Decreased/Absent breath sounds on injured side (using stethoscope)
  • Sounds include: congestion, wheezing, or crackles
  • Auscultate anterior and the lateral thorax
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5
Q

Rib fractures

A

MOI: external blunt force
Rarely LT but can cause damage to the organ or surrounding major blood vessels
more dangerous with mult. #

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6
Q

What situations should you suspect a rib fracture

A
  1. patient resp. presents as pain and shallow or labored
  2. they attempt to ease the pain by leaning toward the side of the # (mostly forwards)
  3. they try to stabilize the # by putting pressure on the injured area
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7
Q

Care for Rib fracture

A

only for simple rib fractures
1. semi-fowler
2. support + mobilize w/ soft object (pillow/blanket)
3. provide O2 if needed (RTD if it is needed)

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8
Q

Complication w/ Rib #

A

Flail Chest
Hemothorax
Pneumothorax

ALL RTD

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9
Q

Flail Chest

A

mult. rib # results in section of the rib cage breaking free from the surrounding tissue
the loose section will not move normally during respiration (Paradoxal breathing: will move opposite in expir and inspir.)

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10
Q

Flail Chest treatment

A
  • Perform a focused exam on the ribs
  • Stabilize flail segment
    (bulky segment extending over boarders, “plaid” pattern)
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11
Q

Hemothorax

A
  • bleeding into the pleural space due to blunt/penetrative trauma causing lacerated lung or laceration of blood vessel in chest
  • affected lung may collapse > respiratory failure
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12
Q

s/s of hemothorax

A
  • cyanosis
  • flat neck veins
  • dyspnea (first)
  • breath sounds absent, dull to percussion
  • shock
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13
Q

closed hemothorax tx

A
  • care for respiratory distress/arrest w high O2
  • assisted ventilation (<10, >30) talk them thru it
  • RTD
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14
Q

open hemothorax tx

A
  • cover w non occlusive dressing
  • monitor for saturation (replace as needed)
  • hypoxic = supplemental O2
  • position of comfort for breathing (recovery = injured side down)
  • assisted ventilation (less than 10, more than 30)
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15
Q

Pneumothorax

A

air entering the pleural space around the lung
- lung can be partially/fully collapsed
- one-time = a simple pneumothorax
- MOI: blunt trauma, penetrating trauma, spontaneous

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16
Q

s/s of pneumothorax

A
  • pleuritic chest pain (increase w cough, deep inhale)
  • dyspnea and/or tachypnea
  • decreased or absent breath sounds on affected side
  • subcutaneous emphysema
17
Q

spontaneous pneumothorax

A

pneumothorax appear in otherwise healthy person w/o trauma; young, thin, tall men
- sudden SOB after exertion, chest pain, coughing, air travel

18
Q

tension pneumothorax

A
  • simple pneumo turns into a tension pneumo
  • when the lung tissue is torn causing a continual flow of air into the pleural space
  • lung will collapse
  • puts pressure on unaffected lung, heart and major blood vessels
19
Q

s/s of tension pneumothorax

A
  • tachycardia
  • hypotension
  • Tracheal deviation
  • Jugular vein distension
  • hypoxia signs (rapid breathing, SpO2, increase HR, pallor, moist skin)
20
Q

tension pneumothorax tx

A

supplemental oxygen
patient positioning (semi-fowler if no spinal)
assisted ventilations
RTD

21
Q

subcutaneous emphysema (SCE)

A

(Rare) air gets trapped in tissues beneath the skin, often due to penetrating trauma to lungs and bronchial tubes
- affected area appears swollen
- crackling sensation on palpation

22
Q

Penetrating Chest injuries

A

a object penetrating any structure within the chest
- disrupts the intrathoracic pressure which prevents the lungs from functioning properly

23
Q

Penetrating chest injuries treatment

A

-internal/external bleeding
- respiratory distress/arrest as presented
- control external hemorrhaging
- DO NOT let wound become occluded
(increase risk of tension pneumo, don’t let dressing to become saturated w/ blood)
- RTD

24
Q

Commotio Cordis

A

lethal disruption of heart rhythm due to blow directly to the heart at critical time during cycle of heart beat causing cardiac arrest

25
Q

Abdominal Injuries S/S

A
  • Severe pain
  • Bruising
  • External bleeding
  • Nausea and vomiting
  • Pale, moist skin
  • Thirst
  • Pain, tenderness/ tight feeling in the abdomen
  • distension in the abdomen
  • organs possibly protruding
  • s/s of shock
  • Suspect one if MOI suggests one (even if S/S dont match)
26
Q

Abdominal Injuries Care

A

Closed:
- treat for shock
- knee bent w/ blanket under

Open:
- treat for external bleeding
-trauma dressing w/ gentle pressure

27
Q

Kidney Injuries S/S

A

MOI = blow to back
- Spasm/rigidity of back musculature
- Severe pain
- S/S of shock
- Nausea / vomiting
- Hematuria (blood in urine)

28
Q

Spleen Injuries

A

Produces RBCs, WBCs, + lymphatic function
- direct blow might cause a rupture resulting in severe internal bleed
- Highly susceptible to injuries when person has mononucleosis
* mono = spleen swollen and drops bellow ribs

29
Q

Spleen Injuries S/S

A
  1. Abdominal Rigidity (LUQ)
  2. Nausea
  3. Kehr’s sigh (pain referred to lower left chest and shoulder area; approx. 1/3 down the left arm)

RTD

30
Q

Femoral Triangle

A

(lateral to medial)
Femoral nerve
Femoral Artery
Femoral vein

31
Q

Pelvic Injuries

A
32
Q

Pelvic Injuries S/S

A

S/S of abdominal injuries
Severe pain
Pelvic Pain
Pelvic instability
Crepitus
Bumbness in legs
Paralysis
Rectal, urethral or vaginal bleeding

33
Q

Pelvic injuires Care

A

-Similar to abdominal
- minimize movement
- control external bleeding
- treat for shock
- avoid pressure on pelvis
- pelvic binder

RTD

34
Q

Bladder injuries S/S

A
  • more susceptible when organ full
  • may be associated w/ fractured pelvis
  • feeling have to urinate but can’t
    hematuria
    -Check next 48hrs for blood or other symptoms
35
Q

Scrotal Contusion MOI + S/S

A

MOI = Blow resulting in testicular spasm, lower abdomen + pelvic pain
- severe pain and disability
- hemorrhaging
- swelling
- muscular spasm
- nausea/vomiting
- Shock

36
Q

Scrotal contusion care

A

DO NOT pump legs or lift and drop the athlete (can be associated w/ #s)
- have them roll into a ball on their back
- ice (no heat)
- have them check testes in place

37
Q

Spermatic Cord Torsion

A
  • dull pain
    -cluster or swollen veins
  • heavy feeling in scrotum

RTD

Z - AET 261 (6 decks)

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