Chest Trauma : The Deadly Dozen Plus

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Chest Trauma The Deadly Dozen Plus

• David A. Meurer, MD
• Department of Emergency Medicine
• University of Florida
• College of Medicine

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So Whats the Big Deal

• ?

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So Whats the Big Deal

• Not the 1 Cause of Trauma Deaths

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So Whats the Big Deal

• Not the 1 Cause of Trauma Deaths
• Who?

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So Whats the Big Deal

• Not the 1 Cause of Trauma Deaths
• Who?
• What?

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So Whats the Big Deal

• Not the 1 Cause of Trauma Deaths
• Who?
• What?
• Where?

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Alphabet Soup
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Alphabet Soup

• ABCs

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Alphabet Soup

• ABCs
• SOAP ME

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Alphabet Soup

• ABCs
• AVPU

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Alphabet Soup

• ABCs
• AVPU
• AMPLE history

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Pay Me Now or Pay Me Later
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Pay Me Now Primary Survey

• Find it and Fix It!

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The Deadly Dozen Pay Me Now

• Airway Obstruction

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The Deadly Dozen Pay Me Now

• Airway Obstruction
• Tension Pneumothorax

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The Deadly Dozen Pay Me Now

• Airway Obstruction
• Tension Pneumothorax
• Open Pneumothorax
• Aka Sucking Chest Wound

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The Deadly Dozen Pay Me Now

• Airway Obstruction
• Tension Pneumothorax
• Open Pneumothorax
• Flail Chest

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The Deadly Dozen Pay Me Now

• Airway Obstruction
• Tension Pneumothorax
• Open Pneumothorax
• Flail Chest
• Massive Hemothorax

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The Deadly Dozen Pay Me Now

• Airway Obstruction
• Tension Pneumothorax
• Open Pneumothorax
• Flail Chest
• Massive Hemothorax
• Cardiac Tamponade

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Cardiac Tamponade
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Pay Me Now or Pay Me Later
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Pay Me Later Secondary Survey

• Defintive repair may be delayed
• Includes Imaging and Lab Data

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion
• Tracheobronchial
• Tree Injury

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion
• Tracheobronchial Tree Injury
• Blunt Cardiac Injury

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion
• Tracheobronchial Tree Injury
• Blunt Cardiac Injury
• Thoracic Aortic
• Dissection

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion
• Tracheobronchial Tree Injury
• Blunt Cardiac Injury
• Thoracic Aortic Dissection
• Traumatic Diaphragmatic
• Injury

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The Deadly Dozen Plus Pay Me Later

• Simple Pneumothorax
• Hemothorax
• Pulmonary Contusion
• Tracheobronchial Tree Injury
• Blunt Cardiac Injury
• Thoracic Aortic Dissection
• Traumatic Diaphragmatic Injury
• Mediasteinal Transversing Wound

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The Left-Overs Mostly Not So Lethal
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The Left-Overs Mostly Not So Lethal

• SQ Emphesema

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The Left-Overs Mostly Not So Lethal

• SQ Emphysema
• Traumatic Asphyxia

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The Left-Overs Mostly Not So Lethal

• SQ Emphysema
• Traumatic Asphyxia
• Rib and Scapular Fractures

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The Left-Overs Mostly Not So Lethal

• SQ Emphysema
• Traumatic Asphyxia
• Rib and Scapular Fractures
• Esophageal Tears

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• Questions?
• meurer_at_emergency.ufl.edu