Lecture52_Chest Trauma, Cardiac Tamponade & Tension Pneumothorax - Impact on Circulation

B c d e airway stabilization c spine control breathing

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Unformatted text preview: on A. B. C. D. E. Airway stabilization (c-spine control!!) Breathing and ventilation Circulation with hemorrhage control Disability/neurologic status Exposure Chest Wall Injury Intact chest wall absolutely essential for normal respiration – maintains the negative pressure 50% of individuals with thoracic trauma will have chest wall injury n n n 10% minor – e.g. broken rib or so 35% major – e.g. multiple rib fractures 5% flail chest Includes Soft tissue injury, Rib Fractures, Sternal Fractures, Sternoclavicular dislocations Rib fractures Break at point of impact or posterior angle Ribs 4-9 most commonly broken n n Ribs 1-3 well protected by clavicle etc. Marker for severe intrathoracic injury Ribs 9-12 mobile anteriorly Marker for intraabdominal injury (liver, spleen, kidney) Single rib fracture n n May limit ventilation and cough reflex secondary to pain – may lead to pneumonia Conservative management Flail Chest >2 adjacent ribs fractured at two points Mortality 8-35% Respiration adversely affected n n Free segment moves paradoxically w/ breathing (decreases volume for expansion when breathing in) Frequently underlying pulmonary contusion – pressure that broke the ribs usually transferred to underlying lung so it will not work properly – faulty oxygen...
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This document was uploaded on 01/10/2014.

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