Trauma Flashcards
S/S of Tension Pneumothorax
Tracheal Shift (Late on external exam, early on radiographic)
Decreased / Absent lung sounds
JVD
Treatment of Tension Pneumothorax
Needle thoracostomy (2nd ICS mid-axillary, 4th-5th Mid-axillary) Tube thoracostomy (5th ICS Anterior Axillary)
S/S of Hemothorax
Midline Trachea
Decreased / Absent breath sounds
Hypovolemic shock
Flat neck veins
Treatment of Hemothorax
Tube thoracostomy (5th ICS Anterior Axillary)
Crystalloid / Blood replacement
Intubate
S/S Open Pneumothorax
Sucking chest wound
Respiratory distress
Tachypnea
Treatment of Open Pneumothorax
Occlusive dressing upon end exhalation
Taped 3 sides until chest tube placement, then 4th
S/S Flail Chest
Paradoxical movement
Respiratory distress
Chest pain
Treatment of Flail Chest
Attempt to stabilize flail chest segment
Injured side down
Limit fluids if available
S/S Early Cardiac Tamponade
Pulsus Paradoxus (Quality of pulse changes with respirations) Sinus Tachycardia
Treatment of Early Cardiac Tamponade
Force Fluids (Increase preload) Anticipate Tamponade progression
S/S Late Cardiac Tamponade
Beck’s Triad (Muffled heart tones, JVD, Narrowed Pulse Pressure)
Treatment of Late Cardiac Tamponade
Pericardiocentesis
S/S Aortic Rupture
Harsh systolic murmur
CXR findings of widened mediastinum
Chest / mid-scapular pain
Treatment of Aortic Rupture
If caval or liver laceration suspected, establish IV access above and below diaphragm
Rapid transport to surgeon
S/S Diaphragmatic Rupture
Bowel sounds in chest
Scaphoid abdomen
Treatment of Diaphragmatic Rupture
NG/OG
NPO
Intubate / PPV
S/S of Tracheobronchial Disruption
Continuous air leak or persistent pneumothorax
Rapidly progressing subcutaneous emphysema
Pneumomediastinum
Treatment of Tracheobronchial Disruption
Supportive
Consider mainstem intubation
S/S of Esophageal Perforation
Hematemesis
Dysphagia
Dyspnea
Shock
Treatment of Esophageal Perforation
NG/OG
Antibiotics
Antiemetics
Newton’s 1st law
Object in motion remains in motion, object at rest stays at rest, unless an outside force acts upon it.
Newton’s 2nd law
F=MA (Force = Mass x Acceleration)
Newton’s 3rd law
Every action has an equal and opposite reaction
Head-on Collison:
Up and Over pattern
Head, neck, chest, pelvis injuries
Head-on Collison:
Down and Under pattern
Knee’s, femur, pelvis, lower back, chest, facial
Rear-end Collision injuries
T12-L1 back injuries
C2 fracture of neck
Evaluate for 2nd impact injury patterns (hitting steering wheel)
T-bone or lateral Collison injuries
Look for injuries secondary to loose objects or other people in vehicle
Motorcycle Head-on injuries
Up and Over
femur, head, neck
Motorcycle Slide / Side injuries
Femur, Pelvic, Tib/Fib