RESPIRATION AND CHEST TRAUMA

Question 1

A NON SHARP OR PENETRATING OBJECT FLYING INTO THE CHEST CAUSES THIS KIND OF INJURY

Answer 1

BLUNT TRAUM

Question 2

PROJECTILE THAT ENTERS THE CHEST CAUSING A SMALL OR LARGE HOLE IS WHAT KIND OF TRAUMA?

Answer 2

PENETRATING TRAUMA

Question 3

CHEST IS CAUGHT BETWEEN TWO OBJECTS

Answer 3

COMPRESSION INJURY

Question 4

OF ALL THE TYPES OF INJURIES TO THE CHEST. THIS ONE IS A LETHAL DISRUPTION IN THE HEARTS RHYTHM DUE TO A HIGH FORCE STRIKE OF THE CHEST.

Answer 4

COMMOTIO CORDIS

Question 5

PRESENT IN 20% OF CHEST INJURIES

• DIVIDED INTO:
• SIMPLE
• OPEN
• TENSION

DEALS WITH AIR ENTERING THE PLEURAL SPACE

Answer 5

PNEUMOTHORAX

Question 6

A PATIENT COMES IN AFTER A FALL FROM SHAFT ALLEY. HE REPORTS CHEST PAIN, DIFFICULTY BREATHING, AND IS TACHYCARDIC. WHEN YOU LISTEN TO HIS LUNGS YOU HEAR NO BREATH SOUNDS ON THE AFFECTED SIDE.

Answer 6

PNEUMOTHORAX

Question 7

THIS PNEUMOTHORAX IS CLOSED AND USUALLY DUE TO A RIB FRACTURE.

Answer 7

SIMPLE

Question 8

PNEUMOTHORAX CAUSED BY A PROJECTILE

Answer 8

OPEN

Question 9

A PERSON WHO HAS RED BUBBLES ON EXHALATION FROM A WOUND TO THE CHEST (SUCKING CHEST WOUND)

Answer 9

OPEN PNEUMO

Question 10

TREATMENT OF A SIMPLE PNEUMO?

Answer 10

IV
O2
MONITOR FOR PROGRESSION INTO SHOCK/ TENSION PNEUMO
MEDEVAC

Question 11

MANAGEMENT OF AN OPEN PNEUMO:

Answer 11

CLOSE THE HOLE WITH AN OCCLUSIVE DRESSING.

CONSIDER E.T. INTUBATION WITH POS PRESSURE VENT SUPPORT.

Question 12

YOU PLACE AN OCCLUSIVE DRESSING OVER AN OPEN PNEUMO AND NOTICE OVER TIME THAT THE PATIENT IS SHOWING RESPIRATORY DISTRESS. WHAT SSHOUD YOU DO NEXT?

Answer 12

OPEN THE DRESSING TO ALLOW THE AIR TO RELEASE.

START CONSIDERING NEEDLE D / CHEST TUBE

Question 13

WHAT IS THE DIFINITIVE TREATMENT FOR A TENSION PNEUMO.

Answer 13

CHEST TUBE

Question 14

THREE CRITERIA FOR USING A NEEDLE D

Answer 14

WORSENING DIFFICULTY WITH A BVM

DECREASED/ABSENT LUNG SOUNDS

BP <90MMHG SHOWING DECOMPENSATED SHOCK.

Question 15

COMPLICATIONS ASSOCIATED WITH NEEDLE D

Answer 15

DEVELOPING A HEMOTHORAX

CELLULITIS FROM BACTERIA EXPOSURE

AIR EMBOLISM

Question 16

GUAGE OF NEEDLE FOR USE OF NEEDLE D.

Answer 16

10-16G

Question 17

ANATOMICAL LANDMARKS FOR A NEEDLE D.

Answer 17

MID CLAV LINE

2ND RIB

2ND OR 3RD INTERCOSTAL SPACE

Question 18

A NEEDLE D IS INSERTED AT WHAT ANGLE AND FOLLOWS ABOVE OR BELOW THE RIB?

Answer 18

INSERTED AT 90 DEGREES AND FOLLOWS OVER THE RIB NOT BELOW THE RIB.

Question 19

A HEMO THORAX CAN HAVE ALL THE SAME SIGNS OF AN OPEN PNEUMO EXEPT YOU MIGHT SEE WHAT GIVE AWAYS?

Answer 19

FLAT NECK VEINS

FROTHY BLOODY SPUTUM

Question 20

WHAT IS THE MANAGEMENT OF A HEMOTHORAX?

Answer 20

IV
O2
MONITOR
TREAT FOR SHOCK

MEDEVAC

Question 21

CHEST TUBE SIZE IN AN ADULT/TEEN MALE:

ADULT/TEEN FEMALE:

Answer 21

28-32 FR FOR MALE

28 FR FOR FEMALE

18 FR FOR CHILDREN

Question 22

WHAT INTERCOSTAL SPACE WILL YOU AIM FOR A CHEST TUBE AN HOW BIG OF A CUT WILL YOU INCISE?

Answer 22

5TH INTERCOSTAL SPACE AFTER MAKING A 2-4 CM INCISION

Question 23

A CHEST TUBE DRESSING SHOULD BE CHANGED OUT EVERY

Answer 23

24 HOURS

Question 24

THE BREAKING OF RIBS IN 2 OR MORE ADJACENT AREAS.

Answer 24

FLAIL CHEST

Question 25

A PATIENT WHO SUSTAINED AN INJURY TO THE CHEST AND NOW YOU SEE PARADOXICAL CHEST MOVEMENT WITH BRUISING/SWELLING AT THE SITE AND NOTED CREPITUS. WHAT IS THE MOST LIKELY DIAGNOSIS?

Answer 25

FLAIL CHEST

Question 26

MANAGEMENT OF A PATIENT WITH FLAIL CHEST.

Answer 26

IV
O2
MONITOR
CONSIDER IV PAIN MANAGEMENT
SPLINT WITH GLOVED HAND AND THEN USE BULKY DRESSING. 
MONITOR FOR PNEUMO AND TRANSPORT ASAP.

Question 27

WHAT SORT OF PAIN MEDS ARE USED FOR A PATIENT WITH FLAIL CHEST.

Answer 27

ANY THAT DON’T DEPRESS THE RESPIRATORY SYSTEM.

Question 28

THIS INJURY IS USUALLY ALWAYS PRESENT IN THE CASUALTY THAT HAS A FLAIL SEGMENT.

• POTENTIALLY LETHAL
• CAN CAUSE RESPIRATORY FAILURE WITHIN THE FIRST 24 HOURS.

Answer 28

PULMONARY CONTUSION