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Cardiorespiratory > Trauma > Flashcards

Trauma Flashcards

1
Q

What is polytrauma?

A

Two or more injuries in at least two parts of the body

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2
Q

What is the fatality rate of a major trauma event?

A

Around 8.5%

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3
Q

What are three mechanisms of injury associated with blunt force trauma?

A
  • Rapid acceleration-deceleration
  • Direct impact
  • Compression
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4
Q

What is an example of low velocity penetrating thoracic trauma?

A

Stabbing

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5
Q

What is an example of high velocity penetrating thoracic trauma?

A

Missile

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6
Q

What injuries can occur from an acceleration-deceleration blunt chest trauma eg MVA, fall?

A
  • Tearing, shearing, rupture and leaks

eg ruptured aorta, pleural injury

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7
Q

What injuries can occur from direct impact blunt chest trauma, eg. steering wheel striking the chest?

A
  • Injury caused by impact - contusion, rupture, tearing

eg fractured ribs or sternum, long contusion

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8
Q

What injuries can occur from compression (blunt chest trauma)?

A
  • Crush injury when tissues strike a fixed object eg sternum - steering wheel
  • Causes fracture, rupture, contusion, tearing
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9
Q

What is the most common thoracic injury?

A

Fractured ribs

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10
Q

Why might a physiotherapist see a patient with broken ribs?

A

High risk for resp deterioration due to:

  • pain
  • possible head injury
  • past medical hx
  • drowsiness
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11
Q

What does an ITLS (International Trauma Life Support) patient assessment consist of?

A

Assesses thoracic trauma

  • Primary survey (life threatening injuries)
  • Secondary surveys (potential life threatening injuries)
  • Tertiary survey (things that may have been missed)
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12
Q

What is a fracture of ribs 1-2 associated with?

A
  • Head injury

- Significant lung and other visceral injury eg aorta

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13
Q

What ribs are most commonly injured?

A

4-9

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14
Q

What injury can ribs 9-12 be associated with?

A

Splenic / hepatic / renal injury

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15
Q

What is flail chest?

A

When two or more ribs are fractured in at least two places

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16
Q

What pathophysiological effects could fractured ribs have on respiration?

A
  • Pain
  • Direct damage, contusion
  • Restrictive lung defect
  • Reduction in gas exchange
17
Q

What potential problems can occur from fractured ribs?

A
  • Atelectasis
  • Reduced alveolar ventilation
  • Retained secretions
  • Pneumonia
  • Resp failure
18
Q

Does a fracture of the sternum tend to have similar respiratory compromise, and require similar physio management, to a rib fracture?

A

Yes

19
Q

What respiratory problems can a lung contusion cause?

A

Significant interruption to alveolar space

  • Gas exchange reduced
  • V/Q mismatch - hypoxaemia
  • Consolidation - hypoxaemia
  • Reduces lung compliance
20
Q

What medical management is used for lung contusion?

A
  • Supplemental O2
  • Increased flow - positive pressure
  • Reduce WOB
  • NIV or invasive ventilation as needed
21
Q

What affect can/does a pneumothorax have on the respiratory system?

A
  • Loss of negative intrapleural pressure
  • Restrictive defect
  • May be space occupying
22
Q

Medical management for pneumothorax?

A
  • Supplementary O2 (helps to maintain SpO2 for small pneumothorax)
  • Fine needle aspiration
  • Chest drain
  • Chemical pleurodesis - procedure using chemicals to stick the lung to the chest wall
23
Q

What is a tension pneumothorax?

A

Occurs when air can enter but not exit the pleural space (medical emergency)

24
Q

Physiotherapy for pneumothorax and tension pneumothorax?

A

Not indicated

  • Treat associated problems eg sputum retention, poor mobility
  • Can be contraindication for positive pressure therapy if undrained
25
Q

How does a haemothorax affect the respiratory system?

A

Similar to pneumothorax

  • Loss of negative intrapleural pressure
  • Restrictive defect
  • May be space occupying
26
Q

Medical management for haemothorax?

A
  • Chest drain
  • Surgery if still leaking
  • Surgical removal if clotting blood or empyema
27
Q

Physiotherapy for haemothorax?

A

Not indicated

- Treat associated problems once drain is in situ, eg sputum retention, poor mobility

Cardiorespiratory (14 decks)

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