EMTChestTrauma - Thoracic Trauma Temple College EMS...

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1 Thoracic Trauma Temple College EMS Professions
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2 Chest Trauma Second leading cause of trauma deaths  after head injury About 20% of all trauma deaths
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3 Chest Trauma Initial exam directed toward: Open pneumothorax Flail chest Tension pneumothorax Massive hemothorax Cardiac tamponade
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4 Rib Fracture Most common chest injury More common in adults than children Especially common in elderly Ribs form rings Consider possibility of break in two places
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5 Rib Fracture Most commonly 5th to 9th ribs Poor protection
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6 Rib Fracture Fractures of 1st, 2nd ribs require high force Frequently have injury to aorta or bronchi 30% will die
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7 Rib Fracture Fractures of 8th to 12th ribs can damage  underlying abdominal solid organs:   Liver Spleen Kidneys
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8 Rib Fracture Signs and Symptoms Localized pain, tenderness Increases when patient: Coughs Moves Breathes deeply Chest wall instability Deformity, discoloration Associated pneumo or hemothorax
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9 Rib Fracture Management High concentration O 2 Splint using pillow, swathes Encourage patient to breath deeply
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10 Rib Fracture Management Monitor elderly and COPD patients carefully Broken ribs can cause decompensation Patients will fail to breath deeply and  cough, resulting in poor clearance of  secretions
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11 Flail Chest Two or more adjacent ribs broken in two  or more places  Produces free-floating chest wall segment Usually secondary to blunt trauma More common in older patients
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12 Flail Chest Signs and Symptoms Paradoxical movement May NOT  be present initially due to  intercostal muscle spasms Be suspicious in any patient with chest wall: Tenderness Crepitus  
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13 Flail Chest Consequences Pain, leading to decreased ventilation Increased work of breathing Contusion of lung
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EMTChestTrauma - Thoracic Trauma Temple College EMS...

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