Chest TraumaAcute Abdomen - PowerPoint PPT Presentation

1 / 7
About This Presentation
Title:

Chest TraumaAcute Abdomen

Description:

Treat with chest drainage, CPT, analgesics. Increased intrathoracic pressure ... Requires surgery or drainage. Traumatic damage ... – PowerPoint PPT presentation

Number of Views:28
Avg rating:3.0/5.0
Slides: 8
Provided by: gtc4
Category:

less

Transcript and Presenter's Notes

Title: Chest TraumaAcute Abdomen


1
Chest Trauma/Acute Abdomen
2
Chest Trauma
  • Penetrating chest trauma
  • Stab wounds and low velocity gun shot wounds
  • Cause hemopneumothorax
  • Manage with chest tubes
  • Cardiac tamponade, mediastinal stab, and large
    blood losses require thoracotomy
  • High velocity gun shot wounds
  • Cause extensive injury/cavitation
  • Hemorrhage, air leaks, and air embolism common

3
Chest Trauma
  • Blunt chest trauma
  • Rib fractures
  • Damage underlying structures
  • Cause severe pain with splinting, atelectasis,
    and hypoventilation
  • More common as you get older because the chest is
    less flexible
  • Treat with chest drainage, CPT, analgesics
  • Increased intrathoracic pressure
  • Abrupt increase in intrathoracic pressure may
    rupture the esophagus, alveoli, and diaphragm
  • Cause mediastinitis, pneumothorax, and herniation
    of abdominal contents
  • Shear stress
  • Organ movement pulls on tissue which is tethered
  • Can cause tears, aortic rupture, hematoma

4
Chest Trauma
  • Tracheobronchial tears
  • Suspect when the 1st and 2nd rib are fx with
    pneumothoraces
  • Spiral tears in the mainstem bronchi are the most
    common, but the trachea can tear longitudinally
    along the posterior wall
  • Lung injuries
  • Pneumothorax/hemothorax
  • Pulmonary contusion bleeding and edema
  • Flail chest
  • Multiple fx result in a free segment of chest
    wall/sternum
  • Paradoxical movement with normal breathing causes
    hypoventilation
  • Discomfort also limits Vt and cough

5
Chest Trauma
  • Diaphragmatic injuries
  • Usually happens on the left b/c right diaphragm
    is protected by the liver
  • High mortality because of associated spleen and
    liver rupture
  • Heart/Great Vessel injuries
  • Cardiac contusion
  • Causes edema and microvascular hemorrhage at the
    site of impactresults in ischemia, arrhythmias,
    heart block, ventricular failure

6
Chest Trauma
  • Heart/great vessel injuries
  • Aortic tears/dissection
  • Due to shearing from abrupt deceleration
  • Most are fatal
  • Pericardial tamponade
  • Aortic root disruption, coronary artery
    laceration, or rupture of the ventricular wall
  • Requires surgery or drainage
  • Traumatic damage
  • May involve the heart, valves (usually aortic),
    papillary muscles, or pericardium
  • Rupture of the ventricular wall is rapidly fatal

7
Chest Trauma
  • Esophageal rupture
  • Suspect if major trauma associated with rapidly
    developing pleural effusion or pneumothorax
  • Prognosis is poor
  • Fat embolism
  • Occurs 1-3 days after multiple long bone or
    pelvic fx
  • Liberated fat/fatty acids lead to emboli
Write a Comment
User Comments (0)
About PowerShow.com