In patients with thoracic trauma and impaired circulation (signs of shock), severe injuries to consider during the primary survey include the following: Massive hemothorax Tension pneumothorax Cardiac tamponade Other chest injuries (eg, blunt cardiac injury, aortic disruption) may cause shock but are not treated during the primary survey.
Full Answer
When is a thoracostomy indicated in the treatment of respiratory distress?
In trauma patients with respiratory distress or shock and decreased breath sounds, tube thoracostomy can be done before imaging studies are obtained.
What is the mortality and morbidity associated with thoracic trauma?
Thoracic trauma causes about 25% of traumatic deaths in the US. Many chest injuries cause death during the first minutes or hours after trauma; they can frequently be treated at the bedside with definitive or temporizing measures that do not require advanced surgical training.
When is a thoracostomy indicated in the treatment of cardiac tamponade?
Persistent systolic blood pressure of < 60 mm Hg due to suspected cardiac tamponade, hemorrhage, or air embolism In trauma patients with respiratory distress or shock and decreased breath sounds, tube thoracostomy can be done before imaging studies are obtained.
Where are the dimensions of the thorax defined inferiorly?
C) The dimensions of the thorax are defined inferiorly by the thoracic inlet. D) The dimensions of the thorax are defined anteriorly by the thoracic vertebrae.
Which of the following is the most common thoracic injury?
Life-threatening injuries diagnosed during the initial trauma evaluation require prompt intervention. Still, the most common injuries due to thoracic trauma are pneumothorax and hemothorax, which are definitively managed in 80% of cases with tube thoracostomy.
Which injuries are considered life-threatening requiring immediate intervention?
Life-Threatening Injuries Injuries requiring urgent intervention, include tension pneumothorax, massive hemothorax, and cardiac tamponade.
What are the common treatments for thorax injuries?
Treatment of Chest Injuries People may be given oxygen (for example, by nasal prongs, by face mask, or through a breathing tube) and intravenous fluids or sometimes blood transfusions. People with severe chest injuries are admitted to the hospital. People may be given pain relievers (analgesics) to lessen pain.
Which injuries are considered life-threatening requiring immediate needle decompression?
Potentially Life-Threatening InjuriesSimple pneumothorax.Diaphragm injury.Blunt aortic injury.Oesophageal injury.
What are the various types of thoracic injuries?
The injuries to be identified and treated in the thoracic region during the primary survey are:Airway obstruction.Tension pneumothorax.Open pneumothorax.Flail chest and pulmonary contusion.Massive hemothorax.Cardiac tamponade.
What types of throat and thorax injuries are life threatening?
Potential life threatening injuries and conditions that may be encountered include flail chest, open chest wounds, pneumothorax, tension pneumothorax, hemothorax, myocardial contusion, cardiac tamponade and diaphragmatic rupture.
What is the most common medical intervention required for patients with thoracic trauma?
Emergency resuscitation, preferential diagnosis, basic interventions (such as thoracentesis or catheter/tube thoracotomy) and effective treatment are the necessary interventions for patients presenting with a trauma.
What are the three types of chest injuries?
Gunshot wounds cause the most penetrating trauma.Broken Ribs. Science Picture Co./Collection Mix: Subjects/Getty Images. ... Flail Chest. A flail chest is broken ribs with an attitude. ... Pneumothorax (Collapsed Lung) The term collapsed lung isn't totally correct. ... Sucking Chest Wound. ... Gunshot Wound. ... Shortness of Breath.
What is the first aid treatment for pneumothorax?
A "sucking" chest wound allows air to enter the person's chest cavity with each breath. This can cause a collapsed lung. Bandage the wound with plastic wrap, a plastic bag, or gauze pads covered with petroleum jelly, sealing it on three sides, leaving one side unsealed.
Can you needle decompress a hemothorax?
Depending on your jurisdiction, needle decompression may be available to providers trained at the EMT, AEMT, or Paramedic level. Providing 100% oxygen via non-rebreather mask or bag-valve-mask is indicated regardless of needle decompressions availability.
Is a flail chest life threatening?
When they move during breathing or other movement, these fractured ends can cause damage to the surrounding muscles, blood vessels, or even to your lungs and heart. This can cause internal bleeding, which can be life-threatening. Flail chest also can make it very difficult for you to breathe.
Is open pneumothorax life threatening?
A tension pneumothorax is a life-threatening situation. It may present with either a closed or open chest injury. The medical provider needs to be keenly aware that there is a high probability of a tension pneumothorax if the patient has an open trauma to the chest wall.
What are the symptoms of a thoracic injury?
Common findings include chest tenderness, ecchymoses, and respiratory distress; hypotension or shock may be present.
What are the most common chest injuries?
The most important chest injuries include the following: Many patients have simultaneous hemothorax and pneumothorax (hemopneumothorax). Bone injuries are common, typically involving the ribs and clavicle , but fractures of the sternum and scapula may occur.
What are the causes of lung damage?
Injuries that directly damage the lung or airways include pulmonary contusion and tracheobronchial disruption. Injuries that alter the mechanics of breathing include hemothorax , pneumothorax , and flail chest . Injury to the lung, tracheobronchial tree, or rarely esophagus may allow air to enter the soft tissues of the chest and/or neck ...
What is a pulmonary contusion?
Pulmonary contusion. Many patients have simultaneous hemothorax and pneumothorax (hemopneumothorax). Bone injuries are common, typically involving the ribs and clavicle , but fractures of the sternum and scapula may occur. The esophagus and diaphragm (see Overview of Abdominal Trauma ) also can be damaged by chest trauma.
What is CT of chest?
CT of the chest is often done when aortic injury is suspected and to diagnose small pneumothoraces, sternal fractures, or mediastinal (eg, heart, esophageal, bronchial) injuries; thoracic spine injuries also will be identified. Other tests for aortic injury include aortography and transesophageal echocardiography .
Is chest x-ray always done?
Imaging studies are typically required in patients with significant chest trauma. Chest x-ray is virtually always done. Results are usually diagnostic of certain injuries (eg, pneumothorax, hemothorax, moderate or severe pulmonary contusion, clavicle fracture, some rib fractures) and suggestive for others (eg, aortic disruption, diaphragmatic rupture). However, findings may evolve over hours (eg, in pulmonary contusion and diaphragmatic injury). Plain x-rays of the scapula or sternum are sometimes done when there is tenderness over those structures.
Can a blunt trauma injure the heart?
Such wounds may injure the hilar or great vessels, heart, tracheobronchial tree, or rarely the esophagus. Patients with symptoms of partial or complete airway obstruction following blunt trauma should be immediately intubated to control the airway.