Flail Ribs

Question 1

What percent of patients with chest wall injury have flail ribs

Answer 1

5-13%

Question 2

Define trauma

Answer 2

Injury or wound that is caused by an external force

Question 3

Two types of chest trauma

Answer 3

Penetrating
Blunt

Question 4

Types of penetrating wounds

Answer 4

High velocity >1500 ft/s
Low velocity <1500 ft/s

Question 5

What differentiates high velocity wounds from low velocity wounds

Answer 5

High- damages the organ and surrounding tissue

Designed to tumble or fragment as they travel

Low- damage tissue and generate bleeding at site

Question 6

Two types of blunt chest injury

Answer 6

Acceleration/deceleration
Compression

Question 7

Trauma assessment groups

Answer 7

American college of surgeons
Advanced trauma life support (ATLS)

Question 8

Components of the ATLS survey

Answer 8

Airway
Breathing
Circulation
Disability
Expose
Female
Glucose

Question 9

What MAP indicates adequate perfusion

Answer 9

Less or equal to 65 mmHg

Question 10

Define shock

Answer 10

Failure of the circulatory system to maintain adequate perfusion to vital organs

Question 11

Difference between obstructive vs hypovolemia

Answer 11

Obstructive: caused by cardiac tamponade and PTX mostly. Can be anything that decreases blood flow

Hypovolemia: blood pools and isn’t delivered to tissue

Question 12

What Glasgow coma scale indicates intubation

Answer 12

<9

Question 13

What is expose/environment include in the ATLS primary survey

Answer 13

Strip and examine

Environment: cover against cold

Question 14

Score a patient using Glasgow come score scale

Answer 14

LOOK AT CAMERAROLL

Question 15

What AVPU

Answer 15

Alert
Responds to Verbal stimuli
Responds to Painful stimuli
Unresponsive to stimuli

Question 16

What is the Secondary survey ATLS

Answer 16

Head to tail assessment
Collect history

Question 17

What does AMPLE stand for

Answer 17

Allergies
Medication
Past medical history/ Pregnancy
Last Meal/ or Intake
Events leading to present illness/ Environmental considerations

Question 18

What does SAMPLE stand for

Answer 18

Signs/ symptoms
Allergies
Medication
Past medical history/ Pregnancy
Last Meal/ or Intake
Events leading to present illness/ Environmental considerations

Question 19

When does a contusion start to blossom

Answer 19

Within 48hrs

Question 20

Describe pulmonary contusion

Answer 20

A bruising of lung itself

Blunt force

Hemorrhage and alveolar relax

Chest images show focal consolidation

Question 21

Define flail chest

Answer 21

Fracture of three or more ribs in two or more places

Question 22

What causes compression injuries

Answer 22

Crush injuries

Primary blast injuries

Question 23

Cause of acceleration/deceleration injuries

Answer 23

MVC’s
Falls
Sport injuries

Question 24

How does flail chest increase WOB

Answer 24

As the patient inhales impaired side collapse

As they exhale stale air enter impaired (trapping)

Question 25

How does Pendelufft develop

Answer 25

Stale air enters the impaired lung and mixes with good high oxygenated blood

Question 26

How is flail chest diagnosed

Answer 26

Clinical diagnosis and imaging

Question 27

What do you do for extreme flail chest

Answer 27

Surgery

Question 28

What non-surgery practice can be done to stabilize chest wall

Answer 28

Apply pressure externally and reduce chest wall expansion.

Question 29

Should chest flail patients require mechanical ventilation

Answer 29

59% due with leading complications being: PNA ARDS Sepsis Death

Question 30

Role of invasive and non-invasive ventilation with flail chest

Answer 30

Distention the lungs open to prevent damage.

Question 31

What does AVPU stand for

Answer 31

Alert Verbal Pain Unresponsive