Card Set Information
AMS1T1 Chest Trauma
Chest Trauma, Thoracic injury, PE
Basic facts about chest trauma
Thoracic injury – causes death in 20-25% of trauma victims
Chest wall injury – 45% of thoracic traumas
: Blunt trauma, Penetrating trauma
Air in pleural space – collapsed lung
Closed – no open wound
Open – chest wall open, ie wound Stab, gunshot, surgical
Tension Pneumo – air rapidly entering pleural space--> Tension on heart/vessels-->EMERGENCY!
--treated with chest tube to Remove air/fluid from pleural space and encourage Re-expansion of lungs
Blood in intrapleural space
May be hemopneumothorax
Most common chest trauma injury
Multiple rib fx – unstable chest wall – Flail Chest (with inspiration, one side of chest will collapse instead of expand. Think asymetrical expansion)
--aka Paradoxical movement to intact chest
Fluid in the pleural space
Sign of serious disease
: noninflammatory conditions – accumulation of protein-poor, cell-poor fluid. Caused by 1. incr hydrostatic pressure of HF (most common); 2. decr oncotic pressure (hypoalbuminemia) from chronic liver or kidney dz.
: contains pus. Pneumonia, TB, lung abscess, post op infection.
: diagnostic & therapeutic.
Pulmonary Embolism (PE)
Thrombus, air or fat, tumor blockage of pulmonary arteries
Gains venous access then pulmonary circulation
DVT, R heart, pelvic veins
Mortality 30% without tx; 2-8% with tx.
: pt may be purple from head to nipple level.
Risk factors for PE
Hx of thromboembolism
Smoking + estrogen therapy
SnSs of PE
: anxiety, sudden dyspnea, tachypnea, tachycardia
“Classic sx triad”
: dyspnea, chest pain, hemoptysis (only 20% display these sx)
Mild/mod hypoxemia – low PaCO2
Cough, pleuritic CP, hemoptysis, crackles, fever, incr pulmonic heart sound (S3 & S4), mental status change
Collaborative care of pt w/PE
O2 – cannula/intubation
Pink, frothy sputum.
Diagnostics related to PE
VQ (ventilation/perfusion) scan
Lung CT scan, spiral CT