blunt or penatrating injuries OR a combination of blunt and penetrating injuries to chest wall and lung parenchyma
chest trauma
associated w/ deceleration, acceleration, or compression injuries (nothing went through the chest wall)
blunt trauma
deceleration =
MVA
falls
acceleration =
blast injuring from explosion
struck w/ blunt object (bat, pipe)
low- speed penetrating trauma
knife wounds
high-speed penetrating trauma
velocity most imp factor in predicting severity (gun shot)
abnormal accumulation of air in the subcutaneous or soft tissues seen on chest xray
subcutaneous emphysema
affted area of the chest wall moves inward w/ inspiration or outward w/ expiration is termed
paradoxical chest movement
worsened w/ positive pressure ventilation. persistent leakage of air into the pleural space despite proper chest tube placement and suction.
rare. treatment includes rapid repair of the underlying injury.
bronchopleural fistula
compression of the heart due to a build-up of blood in the pericardium.
treatment includes surgery/ emergent needle thoracotomy
cardiac tamponade
defined as an abnormal dilatation of the aorta
blood makes its way btwn the laters of a blood vessel wall, seperating them.
treatment is surgical repair
aneurysm
simple rib fractures usually involves ribs
4-10
simple rib fractures may result in (4)
v/q mismatch
hypoxemia
atelectasis
pneumonia
treatment of simple rib fracture includes
analgesia
two or more fractures on each affected rib that result in a free floating portion of the rib cage
flail chest
flail chest causes
paradoxical chest movement
flail chest trauma usually includes pulm contusion which results in the alveoli and may result in (3)
intrapulm shunting
v/q mismatch due to hypoxemia
inc WOB
treatment of flail chest includes
stabilize the chest wall w/ positive pressure vent
surgical stabilization
-placement of rib plates
-wiring of ribs
associated w/ penetrating chest trauma, but also seen with severe blunt trauma from explosive blasts
open pneumothorax
associated w/ penetrating trauma, air enters the pleural space during inspiration, but cannot exit the plueral space bc the parietal pleura acts as a one way valve
closed or tension pneumothorax
in closed or tension pneumothorax the mediastinum shifts _____ from the affected area
AWAY
when mediastinum shifts away from the affected area, it causes (3)
dec in venous return to the heart
hypotension
shock
presence of blood in the pleural space. can be associated with blunt or penetrating trauma is termed
hemothorax
presence of air and blood in the pleural space is termed
hemopneumothorax
bronchopleural fistula worsens with what type of ventilation
positive pressure ventilation
flail chest treatment
positive pressure vent
surgical
-rib plates
-wiring of ribs
general trauma treatment (7)
o2 therapy
hyperinflation
mech vent
airway management/sucction/broncho hygiene
chest tube placement
iv fluids or blood
pain management
associated w/ blunt chest trauma when lung impacts against the chest wall. alveolar microvascular damage allows blood to enter alveoli is termed as
pulm contusion
results from a penetrating injury. result in a sliding motion and the tearing of the lung parenchyma.