Flashcards in Trauma #1 Deck (19):
Radiological evidence of tracheal shift, early or late sign?
Early (down low)
Cyanosis and Hgb considerations
Cyanosis will not exist if Hgb is less than 5
Chest dart & tube lateral placement
Dart: 4th or 5th mid or anterior auxiliary line
Tube: 4th anterior
Positive pressure ventilation & pulmonary contusions
Aggressive PPV Can cause an air emboli
#1: hypovolemia shock
-can dump entire blood volume into chest
-blood loss enough to kill pt
No midline tracheal shift
Flat neck veins
Little tension in chest.
Chest dart: minimal pressure relief
chest tube is ideal
Intubated for ventilation failure.
Occlusive dressing considerations
Tape 3 sides initially
-placement t on end-exhalation
Tape 4th side only after chest tube placement.
Paradoxical movement in conscious pt
Pain stabilizes flail w/ muscle tension. Paradoxical movement only notable on NMBA's or unconscious pts.
Treatment of flail
intubation w/ PEEP (stabilization from within)
Injured side down.
Confused lung beneath leak fluids: pulmonary edema. Limit fluids as able.
Signs of early cardiac tamponade
Sinus tachycardia, pulsus paradoxus
Abnormally large decrease in in systolic pressure and pulse wave amplitude during inspiration
-normal fall is less than 10 mmHg
-when feeling a pulse, quality of pulse decreases on inspiration
Early tamponade treatment
Force fluids, anticipate progression
Late tamponade s/s
Severe hypotension, Becks triad
Muffled heart tones, JVD, Narrowed pulse pressure
Late tamponade treatment
-set pt to 30% angle
-direct needle to inferior scapular margin,
-pull off 15-30 cc blood
-ectopy will be seen if needle hits heart (back needle out)
Cardiac tamponade causes what kind of failure. How do you normally treat this type of failure?
-heart is compressed and cannot open completely at contraction.
-loss of preload, ejection fraction fails
Treatment: force fluids in effort to increase preload
Aortic rupture s/s
Severe CP into back, mid scapular pain,
-HTN in upper extremities (flow to legs limited, diverted to arms)
-Harsh systolic murmur
-wide mediastinum on cxr