Chest Trauma

marissatalley9's version from 2015-06-21 16:35


Question Answer
blunt traumafew external signs, rapid deceleration, compression, examine scene
blunt traumacaused by: falls, motor vehicle crash, vehicle-pedestrian impain, crush, inhalation injury
penetrating traumaentrance chest wall, may= open chest wound allowing atmospheric air to enter pleural space, interfers w/ gas exchange
penetrating traumacaused by: stab, gunshot, blow
upper 1st 3 rib fracturesconsiderable trauma, ex. aortic/tracheal/lungs/spinal
middle 4th-9th rib fractureblunt trauma, lungs, pleural, pulmonary contusions, bruise, tears, pneumo/hemothorax
lower rib fracturesmore flexible, fracture less, vascular organs liver, spleen, kidney
rib fractures compromiserespiratory status by: shallow breathing= pneumonia, atelectasis, hypoxemia, puncture/injury=pneumo/hemo
fractured rib medical managementno taping, control pain, avoid excessive activity, treat associated injuris, encourage turn cough deep breath, HOB up, splinting, surgical rare
flail chest2 or more adjacent ribs are fractured at 2 or more sites= free floating rib segment= decreased chest wall stability, respiratory distress
flail chest paradoxical movementinspiration- chest expands, detached segment (flail) gets pulled in an decreased air into lungs
flail chest paradoxical movementexpiration- flail segment bulges out impairing ability to exhale, mediastinium shifts back to affected side
flail chest assessmentextreme respiratory distress- symptoms immed.
flail chest s/sextreme respiratory distress, hypoxia, cyanotic, severe dyspnea on inspiration, rapid shallow grunting, evere chest pain, sock, paradoxical respiration, breathlessness, dyspnea, tachycardia
flail chest cardiopulmonary effectsaltered respiratory staus= decreased gas exchange= pendulum air
flail chest cardiopulmonary effectsineffective airway clearance= decreased effective coughing, increased secretions = hypoventilation, hypoxemia
flail chest cardiopulmonary effectsimpaired cardiac status= mediasternal structures sway back & forth, increased venous pressure, decreased BP
flail chest managementchest wall stabilization, intensive resp. care, clear lung secretions, control pain, control hemorrhage, prevent infection, relieve abdominal distension, monitor fluid intake & replace fluids
pulmonary contusioncaused by blunt trauma or flail chest
pulmonary contusionedema local or generalized- 1st from bleeding then inflammatory response12-24 hour after injury, symptoms appear, can lead to respiratory distress/death, copious sputum
pulmonary contusion t/mintubation/ventilation, challenge if contusion only one sided
pulmonary contusion s.sincreased SOB, restless, apprehension, chest pain, copious sputum, tachycardia, tachypnea, dyspnea, cyanosis
pneumothoraxspontaneously or due to pre-existing lung disease, blunt or penetrating trauma, iatrogenic (spontaneously)- following thoracentesis
open pneumothoraxcommunication b/w outside body & pleural space through opening in chest- hole
closed pneumothoraxchest wall remains intact & air enters normally though airtight space via lung surface- chest closed
open pneumothorax assessment sucking chest wound, diminished/absent breaths sounds, SubQ emphysema, pain & dyspnea, resp distress, assymetrical chest movement
open pneumothorax t/mvasaline gauze, cover would & apply pressure; closed chest drainage
closed pneumothorax assessment spontaneous, traumatic, tension, severe respiratory distress, subQ emphysema, severe pain, asymmetrical chest expansion, mediastinal shift, JVD, muffled heart sounds
closed pneumothorax t/mconvert tension pneumo to open pneumo by inserting needle to re-expand the lungs
spontaneous pneumothoraxair filled bleb/ blister, ruptures on lung surface, air increased till pressure equalized or lung collapses, cause unknown
spontaneous pneumothorax conservative t/m pain control, respiratory management, activity
spontaneous pneumothorax invasive t/mchest tubes, surgery
hemothoraxblood in pleural space
hemothorax t/mchest tube (evacuate pleural cavity), replace blood loss/ auto transfusion
cardiac tamponadecompression of heart as result of fluid w/i pericardial sac- heart can't fill= decreased cardiac output, heart tones muffled
cardiac tamponade t/mpericardiocentesis and/or chest tube
cardiac tamponade s/sdecreased pulses, JVD, paradoxical pulse
care chest injuriesconservative management, stabilization of chest wall, resp management, closed chest drainage, diagnosis evaluation & monitoring, pain & hemorrhage control, activity needs, surgical interventions, nursing diagnosis supportive, education

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