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Respiratory Emergencies > Thoracic Trauma > Flashcards

Thoracic Trauma Flashcards

1
Q

Ruptured diaphragm happens when

A

Abdominal contents herniate into the chest and compress the lungs, heart, and mediastinum

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2
Q

What side does a diaphragm usually tear on?

A

Left.. the right has the liver to protect you

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3
Q

How can a diaphragm rupture?

A

Air bag – bulls stepping on cowboy stomach

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4
Q

What happens to the heart during diaphragm rupture

A

It gets shifted to the right side of chest - heart sounds over right side

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5
Q

Why does dysphagia happen to ruptured diaphragm

A

Esophagus is all twisted up

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6
Q

Ribs 1-3

A

Short, STRONG
Great force to break

If you break these..it’s probably the least of your problems - 40% die

Great vessel injury

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7
Q

Ribs 4-12

A

Long bone

Easily fractured

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8
Q

What lies under ribs 4-9

A

Lung

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9
Q

What lies under 10-12 on the right

A

Liver

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10
Q

What lies under 10-12 on the left

A

Spleen

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11
Q

Flail Chest

A

Two or more adjacent ribs are fractured in two or more locations or detachment of the sternum

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12
Q

Paradoxical chest movement

A

Free-floating segment of the chest

Doesn’t follow breathing

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13
Q

Why aren’t pulmonary contusions seen often in the ED

A

Develop over time

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14
Q

What is the visceral pleura

A

Adhering to the lung

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15
Q

Adhering to the chest wall is the

A

Pleural cavity

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16
Q

PAIN: Fluid

A

Fluid sinks

Low ache on side of fluid

17
Q

PAIN: Air

A

Air rises

Higher up / radiate over shoulder

18
Q

FREMITUS: Fluid

A

Absent

Sound is absorbed by fluid

19
Q

FREMITUS: Air

A

Decreased

20
Q

Hemothorax can be from

A

Venous - usually self limiting

Arterial - Pressures higher (1500 ml can get stuck in pleural space)

Autotransfusion

21
Q

Arterial hemothorax and you chest tube…

A

Drain..just refills

22
Q

Only tx for hemothorax

A

Thoracotomy

Autotransfusion - while you wait

23
Q

Why can blood from the blood bank not be good?

A

Sitting for 30 days

Some of the RBC have died = hyperkalemia

Highly acidotic - breathing in a bag

24
Q

How do you practice fremitus

A

Have pt say “99” while holding hands against the chest.

Vibrations will transmit through air NOT fluid

25
Q

Egophony

A

“e” while holding a stethoscope near the top of the fluid line

“e” will sound like “a” through fluid

26
Q

Simple Pneumo

A

Air enters the pleural space causing a negative intrapleural pressure

Inside out

27
Q

Open Pneumo

A

Outside in

A penetrating wound

28
Q

Tension Pneumo

A

Accumulation of air in the pleural space that can’t get out

29
Q

Needle thoracostomy

A

Place needle just above the 3rd rib at the midclavicular

14-16 gauge adult
18-20 gauge ped

Respiratory Emergencies (7 decks)

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