Trauma - Chest

Question 1

Main things to worry about after chest trauma (blunt or penetrating)

-Think of this as lungs, chest and other

Answer 1

Lungs

• tension pneumothorax
• open pneumothorax
• hemothorax
• flail chest
• pulmonary contusion

Cardiac

• cardiac tamponade
• aortic disruption
• Cardiac contussion

Other

• diaphragmatic tear
• oesophageal injury

Question 2

Rib fracture

Cause
Sx
Dx
Tx

Answer 2

Caused - blunt trauma but can turn into –> penetrating as rib is sharp
Sx - Chest pain, decrease breath sounds (pain)
–> can lead to atelextasis and pneumonia (elderly)
-sometimes feel crepitus

Dx - Xray
Tx - pain relief (dont overdose opiods)
6 weeks healing

Question 3

Pneumothorax

• Sx
• Dx
• Tx

-small vs large

Answer 3

Cause - penetrating trauma
Symptoms - Dyspnea, resonance, decreased breath sounds

Dx - CXRAy
Tx - throacstomy (top) (chest drain) (after initial needle decompression with a tension pneumothorax)
(if small <1cm - high flow oxygen)

Question 4

Haemothorax

Sx
Dx
Tx

What happens with small and large blood loss?

Answer 4

Cause - penetrating
Symptoms - SOB, dullness to percussion

Dx - Xray - horizontal shadow bottom of lung

Tx - throcostomy at bottom of lungs

–> if blood loss is really high, they need to go to the OT for surgical exploration (thoracotomy) (as it is arterial bleed not pulmonary which is slower)