Unit 4: Pneumothorax Flashcards
What are the different categories of a pneumothorax?
Spontaneous - smaller and self resolve. Spilt into:
Primary - no known cause
Secondary - caused by something else
Tension - blunt or sharp force trauma, normally larger and life threatening.
Air movement into the pleural cavity exerts a positive pressure often causing the lung to collapse
What is a flail chest?
When three or more ribs are broken in two or more places
Move independently of rest of ribcage, move down pressure gradient rather than intercostal muscles (paradoxical movement)
How does TB on a farm effect public health?
Bovine TB is a low public health risk
- All milk sold by supermarkets must be pasteurised
- Regular testing or cattle based on risk rating of area
-cattle are normally vaccination
-infected cattle are isolated and culled
What support is available to a patient at home in a rural area?
GP home visits, GP have higher level of equipment and medication available with them, many GP surgeries are next to a pharmacist.
Charity support - red cross typically provide support just after leaving a hospital
What is the role of an air ambulance?
What conditions do they normally asist?
Private - not part of the NHS
Listen to NHS calls or are contacted by the NHS
Respond to time sensitive emergencies where the NHS are unable to access or unable to get there in time
Examples:
- multiple care collisions
- hanging/drowning with signs of life
- falls from 6m with signs of life
- rural emergencies
- pedestrian v HCG on a high spped road
-prolonged physical entrapment
-major burns
- severe blood loss from uncontrolled bleeding
What is a primary trauma survey?
Intial assessment of a patient in an emergency scenario
Airway - talking, coughing, obstruction
Breathing - rate, sound, depth, even, trachea placement
Circulation - BP, HR, urine levels, capillary refill time, oxygen ,heart sounds
Disability - GCS, blood glucose, pupil dilation and response
Exposure - injury, blood loss, temperature
How does pneumothorax affect the vital signs?
Increased RR
Increased HR
Decreased oxygen saturation
Decreased BP
Confusion - GCS often drops below 13
Patient often has a sharp and sudden pain to the chest, cough and decreased or absent breathing sounds
What is resus and how is it different from A&E?
Resus is a department in A&E
Used for patients who are at high risk of being of may require resuscitation/life saving treatment immediately (medication, ventilation or CPR)
Major trauma, hemorrhage and drug overdose
What is a chest drain?
How is it inserted?
Inserted into pleural cavity, encourages air to leave down a pressure gradient, decreases positive pressure within the pelural cavity, should allow the lung to reinflate.
Use aseptic techniques and anaglesia
Typically along the mid-axillary line in the fourth or fifth intercostal space
What are trauma centres?
Typicallty connected to major hospitals that also have A&E departments. Patients will be triaged into a
Minors - breaks and minor head injuries
Major - significant head or neck injury, loss of consciousness, risk of death or disability
What are classed as strong painkillers?
Generally only available by prescription
Stong opiods: tramadol, fentanyl, diamorphine
What is PTSD?
What are the symptoms?
Occurs within 6 months of the event
Symptoms last longer than 4 weeks
Relive the event - flashbacks, nightmare, hallucinations
Avaoidance of stimuli - social anxiety, fear of locations or action
Increased startle response and hyperarousal
The degree that symptoms interfere with daily life
What are the treatments for PTSD?
CBT - identify the thoughts behind the feelings, change the pattern of thought to more positive outlook, teach more positive styles of behaviour and emotional regulation
Exposure therapy - tackle fear
Eye movement desensitisation and reprocessing - exposure and congitive retraining
What is acute stress syndrome?
What are the symptoms?
Immediately after a traumatic event
Symptoms generally stop within 4 weeks
Similar symptoms to PTSD - nightmares, hallucinations, startle response, etc.
What are the treatments for acute stress syndrome?
Generally self resolves
Anxiety medication
Support groups
May need some psychological support immediatly after an event to reduce the probability of ASS developing into PTSD
