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30 Cards in this Set
- Front
- Back
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1. Confirmation of serious chest injuries?
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a. Most, save for aortic injury, can be confirmed by CXR.
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2. How can aortic injury be diagnosed?
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a. Angiography
b. CT angiography c. Transesophageal echocardiography. |
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3. Initial evaluation w/blunt chest trauma?
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a. ABCs
b. Followed by secondary survey. c. Simultaneously, IV lines should be placed, blood collected, and vital signs monitored. |
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4. What is appropriate w/the presence of diminished breath sounds, chest wall tenderness, and left-sided soft tissue crepitation?
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a. It would be appropriate to place a left chest tube even w/o radiographic confirmation of left pneumothorax.
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5. Treatment of Tension Pneumothorax?
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a. Tube thoracotomy
b. Needle decompression |
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6. Treatment of Hemothorax?
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a. Tube thoracotomy resuscitation
b. Possible exploration, repair |
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7. Treatment of cardiac tamponade?
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a. Decompression (open, needle)
b. Exploration repair |
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8. Treatment of Blunt cardiac injury?
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a. Supportive care (inotropes); operative repair for cardiac rupture.
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9. Treatment of Air emboli?
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a. Exploration, repair
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10. Treatment of Injury to great vessels?
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a. Exploration, repair.
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11. What is critical to assess in the evaluation and treatment of pts w/blunt chest trauma w/respect to the kind of injury?
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a. The magnitude of energy transfer that the accident has delivered to the injured victim.
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12. Good question to ask when assessing multiple injuries?
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a. What will kill the pt first?
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13. What may the identification of rib fractures indicate, esp of upper ribs (first and second)?
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a. The presence of more severe associated injuries such as vascular injuries.
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14. Tx of rib fractures?
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a. Focused on management of the associated pain and the chest wall splinting that may lead to hypoventilation, atelectasis, and pneumonia.
b. Therefore, adequate pain control may require the use of epidural anaesthetic. |
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15. Diagnosis and treatment of rib fractures?
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a. Diagnosis:
1. PE 2. CXR series b. Treatment: 1. Conservative, pain management 2. Pain control to prevent hypoventilation and associated pulmonary complications. |
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16. Diagnosis and treatment of Pneumothorax?
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a. Diagnosis:
1. PE 2. CXR b. Treatment: 1. Tube thoracotomy 2. Should achieve full reexpansion. a. Failure to reexpand or persistent air leak -> consider major tracheobronchial injury. |
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17. Diagnosis and treatment of Pulmonary contusion?
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a. Diagnosis:
1. CXR 2. CT b. Treatment: 1. Supportive care w/ or w/o intubation. 2. Ventilatory support on clinical grounds. |
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18. Diagnosis and treatment of Traumatic Aortic Rupture?
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a. Diagnosis:
1. Aortogram 2. CT angiography 3. TEE b. Treatment: i. Urgent repair. |
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19. How do pts usually present, w/blunt cardiac injury?
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1. Arrhythmia (40%)
2. Cardiogenic shock (45%) 3. Anatomic defect (15%) b. Most pts w/cardiac defects die before reaching the hospital. |
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20. From what does pulmonary contusion result?
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a. From haemorrhage into the alveolar and interstitial spaces.
b. The clinical condition is determined by the severity of the injury and extent of lung parenchyma involved. |
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21. What may severe pulmonary contusions result in?
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a. Significant shunting and hypoxia.
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22. What does pulmonary contusion most commonly result from?
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a. Direct compression of the heart between the thoracic wall and spine.
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23. What should raise suspicion for traumatic rupture of the aorta (TRA) on radiograph?
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a. A widened mediastinum
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24. What is the outcome of TRA determined by?
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a. Whether the rupture is contained by the mediastinal pleura.
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25. Gold standard for diagnosis of a TRA?
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a. Aortogram. However, limitations in access (ie, a separate team is usually required to perform a test).
b. CT angiography is becoming more widely accepted for confirming the diagnosis of TRA. |
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26. Diagnosis of TRA?
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a. Go with CT angiography.
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27. If mediastinal hematoma present on CT angio?
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a. Obvious intimal tear or flap and injury present go with surgical repair.
b. If no injury, address other issues. |
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28. If no mediastinal hematoma present with CT angio and other associated vascular injuries or anomalies suspected?
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a. Go with Aortography.
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29. CXR findings consistent w/thoracic aortic rupture?
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a. Aortic rupture including apical cap
b. Deviated nasogastric tube c. Obliteration of the aortic know d. Hemomediastinum (not Pneumomediastinum). |
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30. complete
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30. complete
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