pnuemothorax Flashcards
(35 cards)
what is ATLS?
advanced trauma life support - standard method for initial management of severely injured patients
- treat biggest threat to life first
ABCDE
what is primary survey?
rapid evaluation airway, breathing, circulation, disability, exposure and environment
what is vital to assessments within ATLS?
imaging - part of primary survey - chest, pelvis, spine, head
FAST - focused assessment with sonography for trauma
describe the airway assessment with ATLS?
assess for patency - foreign bodies and vomit should be removed
exclude facial, mandibular, tracheal and laryngeal injuries
if patient is conscious/ talking - skip airway step
any patient with GCS of 8 or less with a head injury should be intubated
what is the breathing step of ATLS?
patient airway does not guarantee adequate ventilation
lungs/ diaphragm must be assessed for potential injuries that could compromise ventilation
assess for tension pneumothorax, tension haemothorax
what is circulation/ haemorrhage control within ATLS?
haemodynamic state must be established quickly
bleeding is a major preventable death
external bleeding to be dealt with manual pressure asap
ultrasonography within 5Ps
what are the 5Ps to be assessed by sonography?
perihepatic, peri splenic, pelvis, pericardial, pleural
how is disability assessed with ATLS?
neurological examination - GCS
all patients with head injury require a head CT
how do you assess environment and exposure?
patient should be fully exposed - al clothes cut off to allow for full examination
keep patient warm with blankets and ER should be heated
large volume of fluids that patient could require must be warmed
what is BLS?
basic life support
30 chest compressions and 2 rescue breaths
compressions - lower half of sternum at a depth of 5cm for 100-120bpm
what characterised a pnumothorax?
small airways obstruction mediated by inflammatory cells - may manifest as emphysema
what are signs of penumothorax?
cyanosis, sweating, BREATHLESSNESS - can deteoriate to cardioresp distress
what are common clinical signs of pneumothorax?
reduced lung expansion, diminished breath sounds at one side oxygen sats <92%
what is the management of pnuemothorax?
oxygen if dropped sats or SoB
needle decompression - large cannula in 2nd ICS, mid clavicle line
chest drain
what do you aim for with oxygen sats in a patient without COPD?
> 95%
what % oxygen sats do you aim for in a person with COPD?
88-92%
what is responsible for fight/ flight response?
adrenaline and NA - sympathetic NS
what are the three components of the polyvagal theory response to danger?
- immobilisation - freeze response, body shutting down , feeling numb
- mobilisation - SNS helps fight or flight response
- social engagement - after facing threat need to be comforted by those around to engage parasympathetic NS
what is a pneumothorax?
collection of air within pleural space
what is primary pneumothorax?
occurs in a patient without known resp disease
what is a secondary pneumothorax?
occurs in a patient with a known resp disease
what is a tension pnuemothorax?
severe type - medical emergency
the air trapped in pleural space pushes on internal organs - displaces mediastinum structures
haemodynamically compromising
who is more at risk of pneumothorax?
primary - over 65+
males
who is most at risk of spontaneous pneumothorax?
younger slim tall build males
