Traumatic respiratory emergencies Ch 6 Flashcards
How do you manage patients with profuse bleeding of the mouth or nose or who are actively vomiting
In the lateral position
An attempt must be made to insert an oral airway in all patients who are
Unresponsive to verbal stimulation
Limit Suctioning to how long
20 seconds at a time
Four criteria for assisted ventilation
Respiratory rate less than 10 breaths per minute
Presence of cyanosis
Shallow and ineffective respiration
Severe respiratory distress
Ventilate the patient how often?
once every five seconds, time with the patients inhalation if possible
Gen. signs and symptoms of chest injuries
Pain at the injury site
Pleuritic pain that is pain that is aggravated by breathing but is not produced by direct pressure on the chest wall at the site of the injury
Shortness of breath or difficulty in breathing
Failure of one or both sides of the chest to expand normally
Coughing up blood
Rapid and weak pulse
Cool and or moist skin
Cyanosis that is blue color of the lips, fingernails, or earlobes
Subcutaneous emphysema that is air under the skin tissues
Anxiety and fear
Signs and symptoms of rib fractures
History of a blow or compression injury to the chest
Pain at the fracture site or localized tenderness upon palpation
Deep breathing, coughing, or movement usually increases the pain at the fracture site
The patient may often lean toward the Injured side, holding the affected area to keep it in mobilized
The patient usually wishes to remain still
There may be a rib deformity and or chest wall bruising or laceration
Defined flail chest
When two or more consecutive ribs are fractured into or more places or detached from the sternum
Signs and symptoms of flail chest
History of blunt trauma to the chest
Paradoxical movement or deformity, visible on observing the naked chest
Marked shortness of breath and or respiratory distress
Pain in the fracture area
If the lungs are damaged, the patient may:
Cough up blood or frothy, bloody sputtum
Collapse or show signs of shock
Show signs of tension pneumothorax
Define closed pneumothorax
Occurs when lung tissue is torn and air leaks from the lung into the pleural space. Air is therefore contained within the thoracic cavity but outside the lung.
Define an open pneumothorax A.k.a. open, sucking chest wounds
With penetrating wounds of the chest wall, air enters the pleural space from outside the chest wall, thereby collapsing the lung.
Signs and symptoms of an open pneumothorax
History of trauma to the chest
An open chest wound
A sucking sound as air passes through the opening in the chest wall
Blood or blood-stained bubbles expelled from the wound on exhalation
Coughing up blood
Possible exit wound
Defined a tension pneumothorax
It is the accumulation of air in the pleural space under pressure. The air under tension collapses the lung on the side of the injury and then displaces the mediastinum away from the air-filled pleural space, partially collapsing the other lung.
Signs and symptoms of tension pneumothorax
Severe progressive respiratory distress
Distended neck veins due to an obstruction of the superior vena cava
Marked overexpansion on the affected side of the chest
Subcutaneous emphysema
Agitation and restlessness
At deviation or shift of the trachea away from the side of the tension pneumothorax
Define a spontaneous pneumothorax
A pneumothorax that develops without injury. Lungs can develop a weak area on their surface, which ruptures
Define hemothorax
Occurs when blood collects within the plural space.
Define pulmonary contusion
Bruising of the lung
Signs and symptoms of a pulmonary contusion can appear when
Almost immediately in cases of severe injury and up to 12 to 24 hours after the injury
Signs and symptoms of blast injuries
History of an explosion
Pain in the chest and or abdomen
Respiratory distress
Coughing, and frothy sputum which maybe bloodstained
Nausea or vomiting
Shock
A decreased LOC
Bloodshot eyes, minute red or blue spots on the face, neck and or upper chest cause by tiny hemorrhages
Abdominal tenderness and or rectal bleeding
Possible delayed onset of dyspnea, headache, chest pain, or shock
Signs and symptoms of traumatic asphyxia
May have some or all of the general signs and symptoms of chest injury. Specific signs are:
Purple face, neck, and shoulders
Bloodshot eyes, which may bulge
Crushed chest
Cyanotic and swollen tongue and lips
Pulmonary edema usually occurs when
May not be evident for many hours. It usually occurs 8 to 36 hours after the inhalation
Signs and symptoms of smoke inhalation
Sore throat, hoarseness, shortness of breath, swallowing difficulties, and pain on deep inspiration
Cough, especially when it produces soot-tinged sputum
Headache or dizziness, restlessness, confusion, decreased LOC, sometimes convulsions
Respiratory distress with noisy, rapid respiration or a harsh dry cough
Cyanotic or pale-the cherry red appearance once thought to be associated with all carbon monoxide poisoning is, in fact, rarely seen
Facial burns, especially about the mouth and nose