Chest Trauma

Posted by e-Medical PPT
Injuries of chestSimple/Closed Pneumothorax
Opening in lung tissue that leaks air into chest cavity
Blunt trauma is main cause
May be spontaneous
Usually self correcting

Treatment for Simple/Closed Pneumothorax
ABC’s with C-spine control
Airway Assistance as needed
If not contraindicated transport in semi-sitting position
Provide supportive care
Contact Hospital and/or ALS unit as soon as possible

Open Pneumothorax
Opening in chest cavity that allows air to enter pleural cavity
Causes the lung to collapse due to increased pressure in pleural cavity
Can be life threatening and can deteriorate rapidly

Symptoms/Signs of Open Pneumothorax
Sudden sharp pain
Subcutaneous Emphysema
Decreased lung sounds on affected side
Red Bubbles on Exhalation from wound( a.k.a. Sucking chest wound)

Subcutaneous Emphysema
Air collects in subcutaneous fat from pressure of air in pleural cavity
Feels like rice crispies or bubble wrap
Can be seen from neck to groin area

Treatment for Open Pneumothorax
ABC’s with c-spine control as indicated
High Flow oxygen
Listen for decreased breath sounds on affected side
Apply occlusive dressing to wound
Notify Hospital and ALS unit as soon as possible

Tension Pneumothorax
Air builds in pleural space with no where for the air to escape
Results in collapse of lung on affected side that results in pressure on mediastium,the other lung, and great vessels

Needle Decompression
Locate 2-3 Intercostal space midclavicular line
Cleanse area using aseptic technique
Insert catheter ( 14g or larger) at least 3” in length over the top of the 3rd rib( nerve, artery, vein lie along bottom of rib)
Remove Stylette and listen for rush of air
Place Flutter valve over catheter
Reassess for Improvement

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