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

Compression of the ipsilateral and contralateral

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Unformatted text preview: ular diastolic filling and thus impaired left heart output. Compression of the ipsilateral and contralateral lungs also occurs. In both conditions: Primary pathological effect is decreased cardiac output Respiratory impairment is a secondary effect Threat to life is due to cardiac impairment Both conditions are acutely lifethreatening Rapid therapy is required for both conditions Cardiac Tamponade: Causes Penetrating Injury (icepick, knife, bullet etc.) Blunt Injury with cardiac contusion Collagen Vascular Disease (eg. SLE) Renal or Hepatic Disease Malignancy (pericardial metastases) Congestive Cardiac Failure Infection (eg. Staph., TB, Viral pericarditis) Post Operative (diagnostic tap, heart surgery) Cardiac Tamponade Cardiac Tamponade Cardiac Tamponade Cardiac Tamponade: Clinical Signs Evidence of penetrating injury Evidence / history of predisposing condition Dyspnoea Low-blood pressure, SHOCK Distended neck veins Quiet heart sounds Low-voltage electrocardiogram Distended Neck Veins (CVP↑) Low-Voltage ECG Cardiac Tamponade: CXR Cardiac Tamponade: Echocardiogram Cardiac Tamponade: CT Scan Cardiac Tamponade: Treatment 1. Needle Aspiration of Fluid Cardiac Tamponade: Treatment 2. Tube Drainage Cardiac Tamponade: Treatment 3. Open Repair Tension Pneumothorax: Causes Penetrating Injury with lung damage Rupture of pulmonary bulla Spontaneous Pneumothorax: Younger patient Emphyesema: Older patient, smoker Barotrauma Scuba Divers, Miners, Firemen, Construction Worker Iatrogenic: Patients on Ventilators Tension Pneumothorax: Pathogenesis Air escapes from lung parenchyma or airway Air has no where to go, therefore pressure rises Ipsilateral lung compressed, collapses against mediastinum Mediastinum shi...
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This document was uploaded on 01/10/2014.

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