Pfeiffer - Throacic Trauma Flashcards Preview

MED234 Respiratory > Pfeiffer - Throacic Trauma > Flashcards

Flashcards in Pfeiffer - Throacic Trauma Deck (23):
1

Ribs

Always go OVER, never go UNDER (neurovascular bundle here)

2

Mechanism of thoracic injury

1. Blunt (direct or deceleration)
2. Penetrating - (considered intraabdominal if under rib 4-5/the nipple)

3

Blunt mechanism of injury: 2 types

- Direct
- Deceleration forces

4

What type of injury happens to solid organs with blunt force?

Fracture

5

What type of injury happens to holloworgans with blunt force?

Blowout

6

s/s of thoracic trauma

- SubQ emphysema (retroperitoneal air dissection- scrotums or vulva)

7

Deadly dozen thoracic trauma
**primary

**Airway obstruction**
**Flail chest
**Open pneumothorax
**Massive hemothorax
**Tension pneumothorax
**Cardiac tamponade
Myocardial contusion
Traumatic aortic rupture
Tracheal or bronchial tree injury
Diaphragmatic tears
Pulmonary contusion
Blast injuries

8

Airway obstruction - what does it cause?

secondary hypoxia
- ALWAYS assume cervical spine injury

9

Flail chest

**2 or more contiguous ribs broken in 2+ places**
INSPIRATION:
- causes lung volume decrease upon inspiration (neg. pressure)
- mediastinum moves across, compromising the other lobe
- mediatstinum shift torques the vena cava
Opposite upon EXPIRATION.

10

Immediate/field tx for flail chest

External support

11

Monitor for flail chest for...

Pulmonary contusion
Hemothorax
Pneumothorax

12

Sucking chest wound is what?

Open Pneumothorax - air enters pelura and ven impaired, hypoxia results

13

Open pneumothorax tx

Close the hole

14

If you put an open chest seal, do what?

Make sure it doesn't clog. >> would create tension pneumothorax

15

Differentiate MASSIVE hemothorax from tension pneumothorax

MASSIVE = DULL TO PERCUSSION!
all fluid, no air

16

Tx for massive hemothorax:

- Immediate surgical care
- Tx shock
- Fluid admin (to peripheral pulse to 80-90mmHg)
- Monitor for tension hemopneumothorax
(NO decompression)

17

Differential TENSION pneumothorax from massive pneumothorax

TENSION = HYPERTYMPANIC TO PERCUSSION!
-

18

Tx for tension pneumothorax

DECOMPRESSION OF AFFECTED SIDE

19

Do not do what in person impaled?

Do not remove

20

What are s/s of traumatic asphyxia?

- Severe compression (fallen objects)
- Ruptures of the capillaries (petechial injuries)
- Die from petechial hemorrhage in the brain >> Inc. ICP

21

Acuity betweem simple and tension pneumothorax

Simple can wait for tx. Tension cannot wait - immediate necessity.

22

Cardiac tamponade dx

BEck's triad, paradoxical pulse, breath sounds equal

23

Cardiac tamponade tx

- Tx for shock
- Pericardiocentesis if stable
- Fluid admin to peripheral pulse of 8090
- Monitor and tx dysrhythmias
- Monitor for hemothorax and pneumothorax