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13 Cards in this Set
- Front
- Back
Blunt thoracic Injuries
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1/4 of all injury deaths
Comes from direct trauma, compression, acceleration, deceleration |
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Initial Resuscitation
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ABC
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Absent of Abnl breath sounds
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Flial chest - break more then 3 ribs
hemopneumothorax diaphragmatic injury - cant pull down to breath parenchymal lung damage |
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Secure airway
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intubation, surgical airway (if you cant get them intubated), mechanical ventilation
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Cardiac arrest w/ intubation
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poor venous return - hypovolemia, hyperventilation, may inc intrathoracic pressure, further dec venous return to the heart
pulmonary injury preexisting bullou dz Vigorous positive pressure ventilation - tension pneumo, and reduces venous return. |
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Tension Pneumothorax
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Distended neck veins
Hypotension Evidence of hypoprofusion diminished or absent breath sounds tracheal deviation to the contralateral side. TX: immediate needel decompression |
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Massive hemothorax
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injury to the lung parenchyma
intercostal artery/ internal mammary artery Each hemithoria - 40% of pts circulating blood volume defined as - at least 1500ml, two/thirds of space in the hemithorax Dx - CXR Tube thoracostomy - dx and tx Operative - take out 1500ml immediatelly then 200ml ob blood perhour for 4 hours |
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Open pneumothorax
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sucking chest wound - can actually see the lung, put three sided dressing so that a tehy breath in nothing come in and breaths out can get air out but then it will close
Tx - 3 sided dressing. |
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Flialed chest
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free-floating segment of ribs no longer connceted to the res to the thorax
Tx: maintain adequate O2, resp failure is common so may need to intubate -If 3 or more ribs are borke, they may work opposite the rest of the lung, and could cause a tension pneumo. |
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Pulmonary contusion
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Direct injury to the lung - hemorrhage and edema, - absecne of pulm laceration
Significat source - severe morbidity mortality - following penetrating and blunt trauma. Lung opacificaiton CXR within 6 hours of blunt trauma are dx Tx: adeq vent, chest physiotherapy, intercostal nerve blocks |
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Esophageal Injuries
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Esophagram - water soluble cotnrast
Flex esophagoscopy |
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Subcutaneous emphysemia
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presumed underlying pneumothorax
even if not visible on the chest radiograph rice crispies or bubble wrap. |
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Rib fx
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no need for an x-ray, it will heal, but do a Cxr if lung injury is suspected.
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