ruptured diaphragm: how it happens and sx

gunshot wounds, stabbing, blunt trauma eg: MVC, sx: dyspnea/tachypnea, dysphagia, abdo pain, sharp epigastric or chest pain, bowel sounds in the chest, decreased breath sounds

commonly occurs as result of MVC or fall from heights with direct impact to chest. sx ECG abnormalities eg: tachy, PVC's, AV blocks, chest pain, chest wall echymosis

Pericardial tamponade sx:

hypotenion, tachycardia or PEA, dyspnea, cyanosis, Beks triad (hypotension, distended neck veins, muffled heart sounds), progressivly decreasing voltage on the ECG complexes

cover with sterile non-porous dressing and tape on three sides: then reasess: if pt develops sx and sx of tension pneumo, romve the dressing and re-assess

chest tube placement:

4th or 5th intercostal apce, anterior axiliary line

managing the chest tube pt: mx and ix immediately and afterwards

tape tube to chest wall and use gauze dx at insertion site/ CXR for placement/ keep unit below level of insertion/ asess and document FOCA/ use DOPE for trouble shooting

indication and contraindications for autotransfusion:

indicated: massive hemothorax: or greater than 500ml collected. contra: infection at site, bowel contants contaminating blood, potential malignancy eg in the lungs, injuries greater than 6 hours old,

why would you cardiac monitor pts with blunt chest trauma?

it may cause blunt cardiac injury and dysrythmias/cardiac conduction dysfuntcion

what does FOCA stand for?

Fluctation: swing: normally present, stops when pnuemothorax resolves: if suddenly/unexpectedly stops be concerned, Output: monitor drainage, any sudden increase seek help, Colour of draininage, Air leak: is there continous bubbling? tubes disconected?

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TNCC thoracic injury

Question	Answer
# to the 7th to 12th riibs may also cause what concurrrent injuries?	liver and spleen injuries
ruptured diaphragm: how it happens and sx	gunshot wounds, stabbing, blunt trauma eg: MVC, sx: dyspnea/tachypnea, dysphagia, abdo pain, sharp epigastric or chest pain, bowel sounds in the chest, decreased breath sounds
blunt cardiac injury	commonly occurs as result of MVC or fall from heights with direct impact to chest. sx ECG abnormalities eg: tachy, PVC's, AV blocks, chest pain, chest wall echymosis
when a traum apt has had chest impact and has a poor cardiovascular response to their injuries, what might you suspect?	blunt cardiac injury
Pericardial tamponade sx:	hypotenion, tachycardia or PEA, dyspnea, cyanosis, Beks triad (hypotension, distended neck veins, muffled heart sounds), progressivly decreasing voltage on the ECG complexes
open chest wounds	cover with sterile non-porous dressing and tape on three sides: then reasess: if pt develops sx and sx of tension pneumo, romve the dressing and re-assess
chest tube placement:	4th or 5th intercostal apce, anterior axiliary line
managing the chest tube pt: mx and ix immediately and afterwards	tape tube to chest wall and use gauze dx at insertion site/ CXR for placement/ keep unit below level of insertion/ asess and document FOCA/ use DOPE for trouble shooting
do you clamp the chest tube during transport?	NO!
what might cause persistent bubbling in the chest tube drain?	trachobronchial laceration
indication and contraindications for autotransfusion:	indicated: massive hemothorax: or greater than 500ml collected. contra: infection at site, bowel contants contaminating blood, potential malignancy eg in the lungs, injuries greater than 6 hours old,
why would you cardiac monitor pts with blunt chest trauma?	it may cause blunt cardiac injury and dysrythmias/cardiac conduction dysfuntcion
what does FOCA stand for?	Fluctation: swing: normally present, stops when pnuemothorax resolves: if suddenly/unexpectedly stops be concerned, Output: monitor drainage, any sudden increase seek help, Colour of draininage, Air leak: is there continous bubbling? tubes disconected?

Created by: jessharries

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