Chest & Abdominal Trauma Terminology

Question 1

hemothorax

Answer 1

accumulation of blood in the pleural space
- may be massive: 2-3mL
- dullness on percussion
- narrow pulse pressure
- hypotension/hypovolemia
- no JVD

Question 2

tension pneumothorax

Answer 2

accumulation of air in the pleural space
- JVD
- hyperresonance on percussion
- subcutaneous emphysema
- hypotensive (late stages) - obstructive shock

Question 3

similarities of hemothorax/tension pneumothorax

Answer 3

• tachypnea
• dyspnea
• cyanosis
• diminished or decreased breath sounds
• tracheal deviation (late sign)
• asymmetrical chest rise

Question 4

deviation

Answer 4

“a departure from the normal”

Question 5

narrow pulse pressure

Answer 5

“when your pulse pressure is less than 25% of your systolic bp”

Question 6

what does JVD stand for?

Answer 6

jugular vein distention

Question 7

JVD

Answer 7

“large vein in neck bulges visibly”

Question 8

hyperresonance

Answer 8

“an exaggerated chest resonance heard in various abnormal pulmonary conditions”

Question 9

subcutaneous emphysema

Answer 9

“rare condition that occurs when air or gas accumulates under the skin, where it’s not normally present”

Question 10

flail chest

Answer 10

“two or more adjacent ribs are fractures in two or more places”

Question 11

adjacent

Answer 11

“close to or near something”

Question 12

signs of flail chest

Answer 12

• bruising
• tenderness
• crepitus
• paradoxical motion with inspiration and expiration (late sign)

Question 13

paradoxical motion

Answer 13

“chest wall moves in on inspiration and out on respiration, in reverse of the normal movement”

Question 14

management of flail chest

Answer 14

• SPO2 and ETCO2 monitoring
• assist ventilations to achieve SPO2 > 94%
• consider CPAP
• contact ALS for advanced airway management

Question 15

CPAP

Answer 15

“machine that uses mild air pressure to keep breathing airways open (while you sleep)”

Question 16

cardiac tamponade

Answer 16

when 25mL of pericardial fluid is in between the visceral pericardium (innermost lining) and parietal pericardium (middle lining)
- excess fluid that builds up in the pericardial sac (puts pressure on heart which prevents it from filling and pumping like needed)
- causes cardiogenic or obstructive shock
- often occurs due to blunt trauma (ex: steering wheel to chest)

Question 17

pericarditis

Answer 17

“swelling and irritation of the thin, saclike tissue surrounding the heart”

Question 18

neoplasm

Answer 18

“a new and abnormal growth of tissue in some part of the body”

Question 19

management of tamponade

Answer 19

• ABC’s
• oxygen
• contact ALS

Question 20

Beck’s Triad

Answer 20

triage of key signs of tamponade
- JVD
- muffled heart sounds
- hypotension

Question 21

other signs of tamponade

Answer 21

• chest pain
• dyspnea
• orthopnea
• narrowing pulse pressure
• electrical alternans
• pulsus paradoxus
• altered LOC

Question 22

orthopnea

Answer 22

“dyspnea that happens when when you’re lying on your back”

Question 23

electrical alternans

Answer 23

“alternating QRS amplitude in any or all leads on an ECG with no additional evident changes in conduction pathways of the heart”

Question 24

pulsus paradoxus

Answer 24

“when your bp decreases with inhalation”

Question 25

evisceration

Answer 25

protrusion of (an) internal organ(s) or the peritoneal contents through a wound

Question 26

peritoneal

Answer 26

"the tissue that lines the abdominal wall and covers most of the organs in the abdomen"

Question 27

management of evisceration

Answer 27

- cover eviscerated contents with moist, sterile dressing - cover moist dressing with dry dress to conserve organ temp - never attempt to place organs back in cavity

Question 28

solid organ injury

Answer 28

- rapid and significant blood loss

Question 29

solid organs most injured?

Answer 29

- liver - spleen

Question 30

liver

Answer 30

largest organ in abdominal cavity

Question 31

spleen

Answer 31

left upper quadrant - 40% of patients have no immediate symptoms - Kehr's Sign (pain in left shoulder)

Question 32

hollow organ injury

Answer 32

- spillage of contents is primary concern (sepsis, wound infection, abscess formation)

Question 33

hollow organs?

Answer 33

- stomach - colon - small intestine

Question 34

stomach injury

Answer 34

not often injured by blunt trauma

Question 35

colon and small intestine injury

Answer 35

more likely to be injured by penetrating trauma than blunt trauma

Question 36

sepsis

Answer 36

"life-threatening medical emergency that occurs when the body's immune system has an extreme response to infection"

Question 37

abscess formation

Answer 37

"a collection of pus surrounded by tissue that forms when the body's immune system tries to fight an infection"

Question 38

management of abdominal trauma

Answer 38

- stabilize patient and rapid transport - position of comfort - oxygen - check for other injuries - reassess every 5 minutes

Question 39

dyspnea

Answer 39

"shortness of breath"

Question 40

pulse pressure

Answer 40

"difference between systolic and diastolic bp"

Question 41

chest resonance

Answer 41

"the vibration in the chest cavity that occurs when someone speaks or sings"