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

Dx diagnosis n pain crepitus paradoxical movement

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Unformatted text preview: transfer etc. Dx (diagnosis): n Pain, crepitus, paradoxical movement Observe for Pneumothorax/Tension Pneumothorax Flail Chest SIMPLE PNEUMOTHORAX SP = Air in the pleural space Affected lung begins to collapse as pleural space expands Caused by puncture wound, rib fracture, or lung defect Simple pneumo usually well tolerated in young, healthy adult – can live on one lung but eventually when pt is older and may have some lung disease they may become dyspnic S&S: dyspnea, pleuritic chest pain, tachypnea, decreased lung sounds Treatment: Have to decompress the pneumothorax by aspirating. More importantly anticipate development of tension pneumothorax, so pt is put in a semi-sitting position unless contraindicated Simple (closed) pneumothorax Source: Rosen Treatment of pneumothoraces Options n n n Observe Needle decompression Chest tube insertion to aspirate the air. OPEN PNEUMOTHORAX (Sucking Chest Wound) Open chest wall injury Air passes through opening into pleural space and remains outside of lung (preferential if diameter> 2/3 of trachea air will preferntially go into pleural space and lung will collapse) gurgling sound during air movement, bubbling wound, dyspnea, tachypnea, diminished breath sounds. Treatment: anticipate tension, cover wound w/ piece of gauze occlusive dressing to form flutter valve (air goes out but none comes in), O2, IV, treat other injuries Communicating pneumothorax Source: Rosen TENSION PNEUMOTHORAX Air enters pleural space and becomes trapped even when breathing out – leads to pressure increase because air is being retained Increased pressure further collapses lung and shifts mediastinum to unaffected side Increased dyspnea and compressed heart and great ves...
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This document was uploaded on 01/10/2014.

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