THORACIC TRAUMA - PowerPoint PPT Presentation

1 / 23
About This Presentation
Title:

THORACIC TRAUMA

Description:

Tearing of organs, blood vessels, and mesentery (attachments) Fractures of lower ribs associated with high incidence of liver or spleen injury ... – PowerPoint PPT presentation

Number of Views:232
Avg rating:3.0/5.0
Slides: 24
Provided by: maryla5
Category:
Tags: thoracic | trauma | spleen | stab

less

Transcript and Presenter's Notes

Title: THORACIC TRAUMA


1
ABDOMINAL TRAUMA
2
Case Chapter 13
  • You respond to a reported industrial injury.
  • Arrive on-scene to find this patient.

What are your treatment priorities?
3
Overview
  • Review anatomy.
  • Review types of injuries
  • Blunt
  • Penetrating
  • Evaluation of abdominal trauma.
  • Management of abdominal trauma.

4
Anatomy
Intrathoracic Abdomen
5
Anatomy
True Abdomen
6
Anatomy
Retroperitoneal
7
Types of Injuries
  • Blunt trauma
  • Penetrating trauma

8
Blunt Trauma
Pathophysiology
  • High mortality
  • Direct compression
  • Solid organ fracture
  • Hollow organ blowout
  • Tearing from deceleration
  • Little external evidence of injury

9
Penetrating Trauma
Pathophysiology
  • Stab wounds
  • l-2 mortality
  • Shock unlikely at scene
  • Peritonitis over next few hours
  • Gunshot wounds
  • 5-15 mortality
  • Injury to abdominal viscera

All penetrating abdominal wounds should be
evaluated at a hospital.
10
Blunt Abdominal Trauma
  • Fracture of solid organs
  • Hemorrhage
  • Rupture of hollow organs
  • High risk of peritonitis
  • Tearing of organs, blood vessels, and mesentery
    (attachments)
  • Fractures of lower ribs associated with high
    incidence of liver or spleen injury

11
Evaluation Scene Size-up
  • Provides clues to
  • Type of injury
  • Path followed
  • Forces involved
  • Important factors
  • Weapon or object involved
  • Distance
  • Force applied

12
EvaluationBTLS Primary Survey
  • Initial Assessment
  • ABCs
  • Rapid Trauma Survey
  • Head, neck, chest
  • Abdomen
  • Look for wounds, bruises, distention.
  • Feel for guarding, tenderness, rigidity.

13
Signs Symptoms
Assessment
  • Wounds
  • Bruises
  • Tenderness
  • Rigidity
  • Guarding
  • Distention

14
Signs Symptoms
Assessment
  • Injury to upper abdomen
  • Assume chest involvement.
  • Use occlusive dressings on penetrations.
  • Injury to chest below nipple line
  • Assume abdominal involvement.

15
Management
  • Treat problems found in the BTLS Primary Survey.
  • 100 oxygen.
  • If abdominal tenderness, load-and-go.
  • Dress wounds.
  • Two large-bore IVs en route
  • NS or RL to maintain BP of 90-100 systolic

16
Management of Evisceration
  • Cover protruding organs with moist sterile
    dressing and/or nonadherent material.
  • Do not try to put organs back into the abdomen.
  • Load-and-go.

17
Management
  • Airway with high-flow oxygen.
  • Monitor vital signs.
  • Dress wounds.
  • IV access en route.
  • Maintain systolic BP at 90-100 mmHg.
  • Monitor cardiac status.
  • Notify medical command.

18
Management
  • Moist sterile dressings recommended.
  • Do not replace protruding organs.

19
Summary
  • Second leading cause of preventable death from
    trauma.
  • Most deaths from delayed treatment.
  • Be alert to mechanisms of injury.
  • Maintain high index of suspicion.
  • Abdominal pain impending shock.
  • Penetrating wounds of the abdomen or tender
    abdomen mean load-and-go.

20
Proper Assessment
  • Scene survey.
  • High index of suspicion.
  • MOI provides clues
  • Objects, distance, and forces involved
  • Signs often develop late.
  • Pain may signal impending shock.

21
Proper Treatment
  • Rapid assessment.
  • Rapid transport.
  • Perform interventions en route.
  • Reassess patient frequently.

22
Continually watch for
shock!
23
Questions?
Write a Comment
User Comments (0)
About PowerShow.com