EMT-Chapter 34-Chest Trauma

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  1. Mediastinum
    The hollow area located in the thoracic cavity between the right and left lungs.
  2. Pleura
    • Visceral pleura: innermost layer in contact with the lungs
    • Parietal pleura: outermost layer in contact with the thoracic wall
    • Between the pleural layers is a potential space.
  3. Pneumothorax
    • Air in the pleural space causing collapse of the lung
    • A hole of the size of a nickle would be deadly.
  4. Sucking Chest Wound
    • An open wound to the chest that permits air to enter into the thoracic cavity.
    • Open chest injury.
  5. Tension Pneumothorax
    • Severe buildup of air and pressure in the thoracic cavity.
    • Air leaking in the chest cavity with no opening through the outer chest wall.
    • Open chest injury.
  6. Flail Segment
    • Two or more adjacent ribs that are fractured in two or more places and thus move independently from the rest of the rib cage.
    • Displays paradoxical movement
  7. Paradoxical Movement
    A section of the chest that moves in the opposite direction to the rest of the chest during the process of respiration. Typically seen with a flail segment.
  8. Pulmonary Contusion
    • Bleeding within the lung tissue that causes a disturbance in gas exchange between the alveoli and capillaries.
    • Often the consequence of a flail segment.
  9. Open Pneumothorax
    An open wound to the chest that allows air to enter the pleural space and cause lung collapse.
  10. Hemothorax
    • Blood in the pleural space, causing collapse of the lung.
    • Filling the space with blood rather than air.
    • Care is same for pneumothorax and shock.
  11. Traumatic Asphyxia
    • Severe and sudden compression of the thorax that causes a rapid increase in pressure within the chest.
    • JVD
  12. Cardiac Contusion
    • A cardiac injury following severe blunt trauma to the chest where the heart is violently compressed between the sternum and spinal column, causing a bruise to the heart wall.
    • Could lead to commotio cordis
  13. Commotio Cordis
    Sudden cardiac arrest that results from a projectile, such as a baseball, striking the anterior chest.
  14. Pericardial Tamponade
    • Blood or fluid filling the fibrous sac around the heart, causing compression of the heart.
    • Usually results from cardiac contusion
  15. Primary Assessment
    • Quickly expose the chest and examine it.
    • If a hole exists, immediately seal it with a gloved hand.
    • If a shot or stab wound is suspected, log roll the patient to assess the posterior body for an exit wound.
    • Look for subcutaneous ephysema (air trapped under the skin giving it a bubbly inflated appearance)
  16. Signs and Symptoms
    • Cyanosis
    • Dyspnea
    • Tachy/bradycardia
    • Hemoptysis: Coughing up blood or blood-sustained sputum
    • Signs of Shock
    • Tracheal deviation
    • Subcutaneous emphysema
    • JVD
    • Drop in systolic blood pressure of more than 10mm during inhalation
  17. Emergency Care to an Open Chest Wound
    • 1. Immediately seal the wound with gloved hand
    • 2. Apply an occlusive dressing to the seal the wound(taped on three sides)
    • 3. CTSly assess the patient's breathing status:
    • -Difficulty breathing
    • -Tachypnea/dyspnea
    • -Severely decreased or absent breath sounds in injured site
    • 4. Flail segments should be splinted.
Card Set
EMT-Chapter 34-Chest Trauma
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