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THORACIC TRAUMA - PowerPoint PPT Presentation


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THORACIC TRAUMA. YOU JUST NEVER KNOW WHEN TRAUMA WILL OCCUR!. INTRODUCTION. Each year there are nearly 150,000 accidental deaths in the United States 25% of these deaths are a direct result of thoracic trauma An additional 25% of traumatic deaths have chest injury as a contributing factor.

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Presentation Transcript
introduction
INTRODUCTION
  • Each year there are nearly 150,000 accidental deaths in the United States
  • 25% of these deaths are a direct result of thoracic trauma
  • An additional 25% of traumatic deaths have chest injury as a contributing factor
reason
REASON

As a Ranger First Responder, you must be able to identify and treat penetrating trauma to the chest!

overview
OVERVIEW
  • Causes of Thoracic Trauma
  • Types, Signs and Symptoms, and Management of Thoracic Trauma
causes of thoracic trauma
CAUSES OF THORACIC TRAUMA:
  • Falls
      • 3 times the height of the patient
  • Blast Injuries
      • overpressure, plasma forced into alveoli
  • Blunt Trauma
  • PENETRATING TRAUMA
open pneumothorax
OPEN PNEUMOTHORAX
  • Develops when penetration injury to the chest allows the pleural space to be exposed to atmospheric pressure - “Sucking Chest Wound”
  • Q- WHAT MAY CAUSE A SCW?
  • Examples Include:
    • GSW, Stab Wounds, Impaled Objects, Etc...
large vs small
LARGE VS SMALL
  • Severity is directly proportional to the size of the wound
  • Atmospheric pressure forces air through the wound upon inspiration
s s open pneumothorax
S/S: OPEN PNEUMOTHORAX
  • Shortness of Breath (SOB)
  • Pain
  • Sucking or gurgling sound as air moves in and out of the pleural space through the wound
management of scw
MANAGEMENT OF SCW
  • Apply an Asherman Chest Seal
    • Occlusive dressing with a release valve
  • Observe for development of a

Tension Pneumothorax

tension pneumothorax
TENSION PNEUMOTHORAX
  • Air within thoracic cavity that cannot exit the pleural space
  • Fatalif not immediately identified, treated, and reassessed for effective management
early s s of tension pneumothorax
EARLY S/S OF TENSION PNEUMOTHORAX
  • ANXIETY!
  • Increased respiratory distress
  • Unilateral chest movement
  • Unilateral decreased or absent breath sounds
late s s of tension pneumothorax
LATE S/S OF TENSION PNEUMOTHORAX
  • Jugular Venous Distension (JVD)
  • Tracheal Deviation
  • Narrowing pulse pressure
  • Signs of decompensating shock
jvd tracheal shift
JVD & TRACHEAL SHIFT

Decreased input and output from the heart with compression of the great vessels

jvd tracheal shift21
JVD & TRACHEAL SHIFT

Increased pressure moves mediastinum and compresses the lung on the uninjured side

management of tension pneumothorax
MANAGEMENT OF TENSION PNEUMOTHORAX
  • Asherman Chest Seal
  • Needle Decompression
  • High flow oxygen (If available)
  • Bag Valve Mask / Intubation
  • Chest Tube (BN CCP/CASEVAC)
slide23

RGR MEDIC

CHEST TUBE INSERTION

needle thoracentesis
NEEDLE THORACENTESIS
  • Locate 2nd or 3rd Intercostal Space at the Midclavicular Line
  • Insert a 14g needle/catheter over the top of the rib (“VAN”) into the pleural space
  • Listen for air escape (WHOOSH!)
  • Leave the catheter in place
  • Reassess
summary
SUMMARY
  • Reviewed anatomy and physiology of the chest
  • Discussed causes of trauma to the chest
  • Signs, symptoms, and emergent management of:
      • OPEN PNEUMOTHORAX

Asherman Chest Seal

      • TENSION PNEUMOTHORAX

Needle Thoracentesis