Flashcards in Pfeiffer - Throacic Trauma Deck (23)
Always go OVER, never go UNDER (neurovascular bundle here)
Mechanism of thoracic injury
1. Blunt (direct or deceleration)
2. Penetrating - (considered intraabdominal if under rib 4-5/the nipple)
Blunt mechanism of injury: 2 types
- Deceleration forces
What type of injury happens to solid organs with blunt force?
What type of injury happens to holloworgans with blunt force?
s/s of thoracic trauma
- SubQ emphysema (retroperitoneal air dissection- scrotums or vulva)
Deadly dozen thoracic trauma
Traumatic aortic rupture
Tracheal or bronchial tree injury
Airway obstruction - what does it cause?
- ALWAYS assume cervical spine injury
**2 or more contiguous ribs broken in 2+ places**
- causes lung volume decrease upon inspiration (neg. pressure)
- mediastinum moves across, compromising the other lobe
- mediatstinum shift torques the vena cava
Opposite upon EXPIRATION.
Immediate/field tx for flail chest
Monitor for flail chest for...
Sucking chest wound is what?
Open Pneumothorax - air enters pelura and ven impaired, hypoxia results
Open pneumothorax tx
Close the hole
If you put an open chest seal, do what?
Make sure it doesn't clog. >> would create tension pneumothorax
Differentiate MASSIVE hemothorax from tension pneumothorax
MASSIVE = DULL TO PERCUSSION!
all fluid, no air
Tx for massive hemothorax:
- Immediate surgical care
- Tx shock
- Fluid admin (to peripheral pulse to 80-90mmHg)
- Monitor for tension hemopneumothorax
Differential TENSION pneumothorax from massive pneumothorax
TENSION = HYPERTYMPANIC TO PERCUSSION!
Tx for tension pneumothorax
DECOMPRESSION OF AFFECTED SIDE
Do not do what in person impaled?
Do not remove
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
Acuity betweem simple and tension pneumothorax
Simple can wait for tx. Tension cannot wait - immediate necessity.
Cardiac tamponade dx
BEck's triad, paradoxical pulse, breath sounds equal