Chest & Abdominal Injuries

Question 1

Open chest injuries

Answer 1

-Caused by penetrating trauma
•Sucking chest wound
•Open pneumothorax
-Must cover immediately

Question 2

Closed chest injury

Answer 2

-Caused by blunt trauma
•Pneumothorax/tension
•Flail segment
•Pulmonary Contusions

Question 3

Flail segment

Answer 3

• Closed Chest Injury
• 2 or more consecutive ribs broken in 2 or more places
• Leads to a floating section/paradoxical movement
• Airway and breathing issue! (Provide high flow O2 or PPV)

Question 4

Pulmonary contusion

Answer 4

• Bleeding within the lung tissue

- Often a consequence of flail segment

Question 5

Pneumothorax

Answer 5

• Accumulation of air in the pleural cavity

- ABC issue!

Question 6

Pneumothorax S/Sx

Answer 6

• Dyspnea
• Chest Pain
• Absent breath sound on injured side

Question 7

Open Pneumothorax

Answer 7

• Caused by penetrating injury
• May create sucking chest wound
• ABC issue!

Question 8

Open pneumothorax Rx

Answer 8

-Cover hole with 3 sided occlusive dressing

Question 9

Tension Pneumothorax

Answer 9

• Continuity of Pneumothorax and starts compressing heart and other lung
• Life threatening emergency
• ABC issue!

Question 10

Tension Pneumothorax S/Sx

Answer 10

• Dyspnea
• Hypotension
• Absent breath sounds
• Tracheal shift
• JVD

Question 11

Hemothorax

Answer 11

• Blood accumulates in pleural cavity instead of air

- Same S/Sx as Pneumothorax

Question 12

Traumatic Asphyxia

Answer 12

-Severe and sudden compression of the thorax causes a rapid increase in pressure in the chest

Question 13

Traumatic asphyxia S/Sx

Answer 13

• Purplish Discoloration from the chest up
• JVD
• Protruding eyes

Question 14

Cardiac Contusion

Answer 14

• Actual bruise of the heart muscle caused by blunt trauma

- Right ventricle most injured

Question 15

Cardiac Contusion S/Sx

Answer 15

• Chest Pain
• Signs of trauma
• Possible irregular pulse

Question 16

Commotio Cordis

Answer 16

• Sudden blunt force applied to the center of the sternum leads to cardiac arrest
• Force applied in the vulnerable portion of the heart rhythm

Question 17

Pericardial (Cardiac) Tamponade

Answer 17

• Trauma causes bleeding into the pericardial sac

- Causes inward compression of the heart

Question 18

Pericardial (Cardiac) Tamponade S/Sx

Answer 18

• JVD
• Signs of Shock
• Narrowing Pulse Pressure

Question 19

If flail segment is felt you should?

Answer 19

-initiate O2 therapy or PPV

Question 20

Never remove impaled objects unless

Answer 20

• Interferes with chest compressions but call medical director first!!
• Impedes ability to maintain an open airway

Question 21

Specific chest signs to watch for during secondary assessment

Answer 21

• Subcutaneous Emphysema
• JVD
• Tracheal deviation

Question 22

Solid organs

Answer 22

• Liver
• Spleen
• Pancreas
• Kidneys

Question 23

Hollow organs

Answer 23

• Gall bladder
• Stomach
• Intestines

Question 24

Open wounds

Answer 24

• Stabbings
• GSW
• Abdominal evisceration (Cover sterile dressing)

Question 25

Closed wounds

Answer 25

• Blunt trauma

- Can hide bleeding and internal injuries

Question 26

Abdominal injuries S/Sx

Answer 26

• Signs of trauma
• Tender upon palpation
• Rigid abdomen
• Fetal Position
• Signs of Shock
• Cramping
• Pain Radiating to shoulder