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29 Cards in this Set
- Front
- Back
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blunt trauma
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chest strikes or is struck by an object
shearing, contusion, laceration |
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penetrating trauma
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OPEN INJURY
gunshot/knife |
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thoracic injury
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simple rib fracture to life threatening organ ruptrue
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pneumothorax def
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air in pleural space
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pneumothorax manifestation - simple/closed
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dyspnea
decreased movement of involved chest wall/absent or diminished breath sounds asymeterical lung expansion subcutanous emphysema hyperesonnance chest tube with drainage, flutter vlave |
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hemothorax
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blood in pleural space
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hemthorax clinical man
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dyspnea
diminished/absent breath sounds dullness to percussion - different from pneumo! decreased hgb NO subcuatnous emphysema - different from pneumo! shock if enough blood is lost - chest tube with drainage - can also autotransfuse |
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tension pneumothorax
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air in pleural spce that does not escape causes shift in organs and increases intrathoracic pressure
lung deflates - as tension builds vent to opposite lung impaired pressure on heart + vessels = deceased CO and venous return |
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tension pneumothorax clinical man
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cyanosis
air hunger agitation trachael deviation away from affected side subcutaneous emphysema PMI shift can progress to shock JVD hyperressonacne needle decompression + chest tube/drainage system - may need to do rapidly |
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flail chest
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fracture of 2+ rivs in 2+ places with loss of chest wall stabililty
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flail chest clinical man
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paradoxic movement of chest wall
respiratory distress hemothorax, pneumothorax, pulmonary contusion O2 therapy, stabilize flail section with ppv |
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cardiac tamponade
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blood collects in pericardial sac, compressed myocardium because pericardium does not stretch - prevent ventricle from filling
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cardiac tamponade clinical man
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muffled, distant heart sounds
hypotension JVD increased CVP decreased BP pulsus paradoxus pericardiocentisis + surgical repair |
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simple rib fracture
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60%
painful to breathe = risk for atelectisis/pneumonia splint with cough heals in 3-6 weeks with no interventions |
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multiple rib fx upper chest comp
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cardiac and major vessel injury
bleeding cardiac tamponade |
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lower rib multiple fx comp
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rt side - spleen
lft side - liver pulmonary contusion! = ARDS |
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dx multiple rib dx
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chest x-ray
ABGs rib series |
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treat multiple rib fx
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agressive pain control (5-7 days of intense pain) intercostal nerve block, PCA
encourage deep breathing - cough do not bind - hypoventilation |
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flail chest def
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2+ ribs fx in 2+ places = unstable chest wall
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flail chest clinical man
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paradoxical motion = classic sign
in with inspiration out with expiration poor tidal volume - hypoxia - dyspnea, anxious, cyanosis, crepitus |
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flail chest complication
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pulmonary contusion
pneumonia |
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flail chest treatment
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good airway - maintain ventilation
pain control - mechanical vent - o2 therapy, splint chest wall cough and deep breathe - medicate for pain |
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pulmonary contusion def
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direct lung tissue damage/injury
leads to pulmonary edema and ARDS |
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pulmonary contusion sx
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localized chest pain, dyspnea, +RR, -TV, hemoptysis,
check ABGs and watch for acute ventilatory failure |
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pulmonary contusion treatment
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o2 and mechanical vent, aggressive pulmonary exercises, antibiotics
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pneumothorax causes
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accumulation of air in pleural space
spontanous (blebs rupture, coughing) blunt/penetrating trauma dislodged CT invasive procedure barotrauma from mechanical vent |
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open pneumothorax
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sucking chest wound
- pressure in plueral space + space in atmosphere lose negative pressure - lung collapse |
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open pneumothorax classic sx
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slurping/sucking sounds d/t air exchange
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open pneumothorax treatment
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seal site quickly to prevent lung collapse
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