Questions and Answers
What can cause a pneumothorax?
Spontaneous pneumothorax is always life-threatening.
False
What can happen if more air occupies the thoracic cavity during pneumothorax?
The lung can collapse.
An open pneumothorax occurs from ______ trauma that creates a hole in the chest wall.
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Match the type of pneumothorax with its description:
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What is the appropriate on scene time for blunt force injuries?
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What is the most common chest injury?
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Penetrating trauma does not require a specific on scene time.
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A fractured sternum is usually not serious on its own.
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What is a flail chest?
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Name two possible signs of a chest injury.
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A __________ can cause myocardial contusion.
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A pneumothorax is defined as __________ in the pleural space.
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Which of the following symptoms is associated with chest trauma?
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Match the following rib injuries to their descriptions:
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Match the type of chest injury with its cause:
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What potential blood loss can occur with a rib fracture?
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The movement of a flail segment causes the underlying lung to become adequately ventilated.
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Patients can never exhibit reduced levels of consciousness after chest trauma.
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What layer of pleura covers the lungs?
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What should you consider for a patient who fell from a height?
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What is a characteristic of a tension pneumothorax?
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A haemothorax typically signifies bleeding in the thoracic cavity that poses a life-threatening risk.
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What are the two main problems faced by a patient with a haemothorax?
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In cardiac tamponade, _____ in the pericardial sac compresses the heart.
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What symptoms might indicate a tension pneumothorax in a patient?
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Match each condition with its primary cause:
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Exposure of the chest is not necessary for the primary survey in assessing a patient with chest injuries.
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What is the minimum amount of blood needed to cause cardiac tamponade?
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The assessment of chest injuries must start with evaluating _____ issues.
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Which of the following features is NOT associated with a tension pneumothorax?
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What is the primary assessment step for a patient with chest injuries?
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Subcutaneous emphysema is always associated with minor thoracic injury.
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What should the target oxygen saturation range be according to JRCALC guidelines?
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The __________ mnemonic is used for assessing chest injuries.
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Which of the following is a contraindication for administering Entonox?
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Match the following assessment actions with their purposes:
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A time-critical transfer should be undertaken if the major chest injuries cannot be corrected.
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Oxygen should be administered at a rate of __________ liters per minute for major trauma.
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Study Notes
Mechanism and Timing of Injuries
- Blunt force injuries from RTC, falls, or sports typically have an on-scene time of less than 20 minutes.
- Penetrating trauma, such as gunshot or stab wounds, requires immediate assistance, often within minutes.
Assessment Considerations
- Evaluate for potential stab or gunshot wounds.
- Assess for crushing injuries, high-speed collisions, or direct blows.
- Take note of the patient's age; elderly or infants may require different care.
- Request assistance from advanced clinicians or emergency services if necessary.
Signs and Symptoms of Chest Injury
- Common indicators include hypoxia, dyspnoea, and changes in respiratory rate (tachypnoea or bradypnoea).
- Look for abnormal chest movement, bruising, swelling, or wounds.
- Assess for pain, tenderness, clinical shock, and consciousness level.
- Severity and urgency can vary widely; consider if the patient is time-critical.
Types of Chest Injuries
- Rib Injuries: The most prevalent chest injury, leading to inadequate ventilation and potential soft tissue damage.
- Myocardial Contusion: Caused by blunt trauma to the sternum, risking cardiac rhythm disturbances.
- Haemothorax and Pneumothorax: Lung damage may result in bleeding (haemothorax) or air leaks (pneumothorax).
- Rapid Deceleration Injuries: Can rupture major vessels like the aorta.
Specific Chest Injury Types
- Fractured Rib: Suspect additional injuries; can cause up to 100ml blood loss and inadequate ventilation.
- Fractured Sternum: Indicates significant risk for major injuries; mortality risk is over 25%.
- Flail Chest: Multiple fractures lead to paradoxical movement of the chest wall, risking inadequate lung ventilation.
Pneumothorax and Related Conditions
- Pneumothorax: Air accumulation in the pleural space; can be spontaneous or due to trauma.
- Open Pneumothorax: A hole in the chest wall allowing air to freely enter and exit during breaths.
- Tension Pneumothorax: Life-threatening; air enters pleural space and accumulated pressure collapses the lung and shifts mediastinal structures.
Haemothorax and Cardiac Tamponade
- Haemothorax: Blood in the thoracic cavity, usually from penetrating injury; time-critical and can cause hypoxia.
- Cardiac Tamponade: Fluid accumulation in the pericardial sac compressing the heart; as little as 20-30ml blood can cause critical issues.
Assessment Tools
- Utilize C ABCDE protocol focusing on catastrophic hemorrhage, airway, breathing, circulation, disability, and request further clinical intervention promptly.
- Conduct a primary survey assessing respiratory patterns, chest wall movement, and physical injuries.
Management Strategies
- Administer 15 liters of oxygen via a non-rebreather mask for major trauma.
- Avoid nitrous oxide for patients with suspected pneumothorax; consider using morphine or IV paracetamol as required for analgesia.
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Description
Test your knowledge on the various mechanisms of chest injuries, including blunt force and penetrating trauma. This quiz will cover the impact of force, energy, duration, and direction in real-world scenarios. Assess your understanding in less than 20 minutes!
