chest trauma-1 - CHEST TRAUMA CHEST TRAUMA Joe Lex, MD,...

Info iconThis preview shows pages 1–19. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: CHEST TRAUMA CHEST TRAUMA Joe Lex, MD, FACEP, FAAEM Joe Lex, MD, FACEP, FAAEM Chestnut Hill Hospital Chestnut Hill Hospital Philadelphia, PA Philadelphia, PA March 16, 1999 March 16, 1999 splinter Where can adults hide blood and go into shock? Chest - listen, do chest x-ray Abdomen - do DPL or CT or US Retroperitoneum - do CT Thigh - physical examination Street - ask paramedic ...and in children, add Head Incidence of Chest Trauma Cause 1 of 4 American trauma deaths Contributes to another 1 of 4 Many die after reaching hospital - could be prevented if recognized <10% of blunt chest trauma needs surgery 1/3 of penetrating trauma needs surgery Most life-saving procedures do NOT require a thoracic surgeon Pathophysiology of Chest Trauma hypovolemia ventilation- perfusion mismatch changes in intrathoracic pressure relationships Inadequate oxygen delivery to tissues TISSUE HYPOXIA Pathophysiology of Chest Trauma Tissue hypoxia Hypercarbia Respiratory acidosis - inadequate ventilation Metabolic acidosis - tissue hypoperfusion (e.g., shock) Initial assessment and management Primary survey Resuscitation of vital functions Detailed secondary survey Definitive care Initial assessment and management Hypoxia is most serious problem - early interventions aimed at reversing Immediate life-threatening injuries treated quickly and simply - usually with a tube or a needle Secondary survey guided by high suspicion for specific injuries 6 Immediate Life Threats Airway obstruction Tension pneumothorax Open pneumothorax sucking chest wound Massive hemothorax Flail chest Cardiac tamponade 6 Potential Life Threats Pulmonary contusion Myocardial contusion Traumatic aortic rupture Traumatic diaphragmatic rupture Tracheobronchial tree injury - larynx, trachea, bronchus Esophageal trauma 6 Other Frequent Injuries Subcutaneous emphysema Traumatic asphyxia Simple pneumothorax Hemothorax Scapula fracture Rib fractures Primary Survey Airway Breathing Circulation A = Airway Assess for airway patency and air exchange - listen at nose & mouth Assess for intercostal and supraclavicular muscle retractions Assess oropharynx for foreign body obstruction B = Breathing Assess respiratory movements and quality of respirations - look, listen, feel Shallow respirations are early indicator of distress - cyanosis is late C = Circulation Assess pulses for quality, rate, regularity Assess blood pressure and pulse...
View Full Document

This note was uploaded on 01/11/2012 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

Page1 / 108

chest trauma-1 - CHEST TRAUMA CHEST TRAUMA Joe Lex, MD,...

This preview shows document pages 1 - 19. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online