Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
What percentage of deaths are due to chest trauma |
25% |
|
|
What is the most serious adverse effect and intervention to correct for chest trauma (highest priority) |
Hypoxia |
|
|
Is hypercarbia a high priority to treat in chest trauma |
Its not good to have but its not on the tope of the list unless they have a head trauma |
|
|
What are some signs in a chest trauma |
1. Increased RR 2. Shallow respiration 3. Cyanosis is a late sign 4. Chest movement 5. Quality of air entry bilaterally |
|
|
Following primary survey what are the common injuries |
1. Tension pneumothorax 2. Open pneumothorax 3. Massive hemothorax 4. Cardia Tamponade |
|
|
1. What is the MOA of tension Penumothorax 2. What happens to the lung 3. What happens to the mediastinum |
1. One way valve causes air to leak into pleural space
2. Trapped air collapses the lung
3. Mediastinum pushed to the other side decreasing venous return and compressing opposite lung |
|
|
What are the causes of Tension Pneumothorax |
1. Positive pressure ventilation (most common) 2. Blunt force 3. Penetrating wound from the outside 4. Rib fracture from the inside 5. Iatrogenic (central line insertion) |
|
|
How do you diagnose tension pneumothorax |
Clinical diagnosis |
|
|
What are the clinical signs of tension pneumothorax |
1. Tracheal deviation 2. Unilateral absence breath sound 3. Respiratory distress 4. Hypotension 5. Neck distension 6. Hyper resonance on same side |
|
|
What is the intervention for tension pneumothorax |
1. Immediate decompression 2. Needle Thoracostomy 3. Large IV bore catheter into anterior chest through 2nd intercostal space (now simple pneumothorax) 4. Definitive treatment is chest tube |
|
|
1. What is an open pneumothorax 2. What happens to the pressure of the thorax 3. Where does air prefer to travel |
1. Sucking chest wound 2. Pressure is equalized with the atmosphere 3. Air prefers to move through any wound larger than 2/3 of the tracheal diameter |
|
|
How do you treat an open pneumothorax |
1. Cover wound with dressing taped on 3 sides (flutter valve = short term)
2. Chest tube as soon as possible |
|
|
1. What is a massive hemothorax 2. When do you suspect it 3. What can blood loss cause 4. What happens if the vena cava is compressed 5. What does compression and collapse of the lungs cause |
1. > 1500 ml in chest cavity 2. Penetrating trauma thats medial to the nipples and scapular border 3. Shock 4. Shock because of diminished venous return 5. Hypoxia |
|
|
1. What does hemothorax often present as 2. What does percussion sound like |
1. Shock 2. Decreased air entry and dullness |
|
|
How do you treat Hemothorax |
1. Large bore chest tube 2. Blood replacement 3. Thoracotomy (chest tube) |
|
|
What causes cardiac tamponade |
Penetrating trauma medial to nipples |
|
|
What is the classic symptoms of Cardiac Tamponade |
Becks Triad 1. Venous Distention 2. Decreased BP 3. Muffled Heart sound (bc blood surrounds ventricle) |
|
|
How do you treat Cardiac Tamponade |
1. IV fluid to improve cardiac output 2. Pericardiocentesis 3. Emergency Department Thoracotemy if there are signs of life (reactive pupil, organized EKG) |
|
|
What are common injuries found in secondary survey |
1. Flail chest 2. Rib fracture 3. SImple Pneumothorax 4. Hemothorax 5. Pulmonary Contusion 6. Cardiac Contusion 7. Traumatic Aortic Rupture |
|
|
What is a flail chest |
when a part of the chest wall doesn't move with the rest of the thoracic cage |
|
|
What causes Flail Chest |
1. Pulmonary contusion 2. Pain 3. Pendaluft = air moves from one lung to the other with breathing 4. Mediastinum shift |
|
|
How do you diagnose flail chest |
Paradoxical movement Splinting and shallow breathing Crepitus |
|
|
How do you treat flail chest |
1. Intubation wit positive pressure ventilation 2. Analgesia and O2 are the FIRST step 3. Give fluid 4. Admit for observation |
|
|
What are the common injuries for the upper 3 ribs, middle 6, and lower 3 |
Upper 3 = big marker for mortality, vascular injury
Middle 6 = Lung injury common
Lower 3 = risk of poking abdominal organs |
|
|
How do you diagnose rib fractures |
1. CXR 2. U/S |
|
|
What is the treatment for rib fractures |
Analgesia |
|
|
What do you have to be cautious of with rib fractures |
Travelling on an air plane can cause positive pressure ventilation due to tension penumothorax |
|
|
If a child comes in with a rib fracture what must you consider |
Its hard to break a kids ribs so consider possible child abuse |
|
|
What are elderly and pregnant patients at higher risks for with rib fractures |
Respiratory failure due to decreased reserve so consider admission if multiple ribs fractures |
|
|
1. What is a simple pneumothorax 2. What are some signs and symptoms 3. How do you diagnose |
1. Small amount of air which is not under pressure 2. Reduced air entry and tympani to percussion 3. CXR but U/S and CT more sensitive (do serial CXR in 6 hours if small <20%) |
|
|
1. What is a hemothorax 2. What are the signs and symptoms 3. How is it diagnosed 4. Treatment |
1. Small amount of blood in pleural space 2. Decreased air entry and dullness to percussion 3. X ray (blunt costo-phrenic angle on upright) 4. Chest tube drainage unless very small |
|
|
1. What are the first signs of pulmonary contusion 2. When can you see it on a CXR 3. When are the peak symptoms 4. What is the treatment |
1. Tachypnea 2. 12-24 hours 3. 48-72 hours 4. O2, analgesia |
|
|
1. What is the MOA for Cardiac Contusion 2. What are the signs and symptoms 3. What is the best predictor 4. How do you treat |
1. Steering wheel blunt trauma 2. Chest pain, dysrhythmia, CHF, cardiogenic shock 3. EKG 4. ACLS protocol
|
|
|
1. What is the MOA for traumatic aortic rupture 2. What are the signs and symptoms 3. What is seen on the CXR 4. How do you treat it |
1. Major blunt trauma to chest 2. Chest pain to back, dysphonia and stridor from compression of trachea and recurrent laryngeal nerve 3. Widened mediastinum, lept apical cap 4. Beta block to cause hypotension to try and keep it from popping) |
