Emergency Care Component 8: Chest Injuries

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Questions and Answers

What condition can occur due to trauma that fills the thoracic cavity with air?

  • Hemothorax
  • Emphysema
  • Pneumothorax (correct)
  • Pleural effusion

A spontaneous pneumothorax can be benign as long as it does not progress to a tension pneumothorax.

True (A)

Name one potential consequence if air continues to accumulate in the thoracic cavity.

Lung collapse, obstructive shock

What percentage of trauma deaths are directly attributed to chest trauma?

<p>25% (D)</p> Signup and view all the answers

Surgery is required for the majority of chest injuries.

<p>False (B)</p> Signup and view all the answers

An open pneumothorax is caused by __________ trauma.

<p>penetrating</p> Signup and view all the answers

Match the following terms with their descriptions:

<p>Spontaneous Pneumothorax = Occurs without obvious cause Tension Pneumothorax = Can cause obstructive shock Open Pneumothorax = Caused by penetrating trauma Blunt Trauma = Common cause for small pneumothoraces</p> Signup and view all the answers

Name one major cause of chest trauma.

<p>RTC, Industrial accidents, or sporting injuries.</p> Signup and view all the answers

The most common problem associated with major chest injuries is __________.

<p>HYPOXIA</p> Signup and view all the answers

Match the following chest injury complications to their description:

<p>Hypoxia = Impaired ventilation or hypovolaemia Rib injuries = Possible liver or kidney injuries Spinal injury = Could affect motor functions Pneumothorax = Air in the pleural space</p> Signup and view all the answers

What is the maximum on-scene time for blunt force injuries?

<p>20 minutes (A)</p> Signup and view all the answers

Penetrating trauma includes injuries such as gunshot and stab wounds.

<p>True (A)</p> Signup and view all the answers

Name one possible sign or symptom of a chest injury.

<p>Hypoxia</p> Signup and view all the answers

A __________ contusion may result from blunt trauma to the sternum.

<p>myocardial</p> Signup and view all the answers

Which of the following could be a cause of chest trauma?

<p>Falling from a height (A)</p> Signup and view all the answers

Signs of clinical shock may include anxiety and reduced levels of consciousness.

<p>True (A)</p> Signup and view all the answers

What could result from rapid deceleration injuries?

<p>Rupture of great vessels</p> Signup and view all the answers

Match the following types of chest injuries with their descriptions:

<p>Haemothorax = Bleeding in the chest cavity Pneumothorax = Air leak in the chest Rib injuries = Tearing and contusion of lung structures Myocardial Contusion = Trauma to the heart muscle</p> Signup and view all the answers

What is the most common chest injury?

<p>Rib Fracture (B)</p> Signup and view all the answers

A fractured sternum is usually a serious injury on its own.

<p>False (B)</p> Signup and view all the answers

How much blood loss can rib fractures lead to?

<p>100ml</p> Signup and view all the answers

Pneumothorax is defined as _____ in the pleural space.

<p>air</p> Signup and view all the answers

Match the injury to its description:

<p>Rib Fracture = Most common chest injury Flail Chest = Loss of rigid segment of the chest wall Pneumothorax = Air in the pleural space Fractured Sternum = Indicates significant probability of other major injuries</p> Signup and view all the answers

Which of the following is NOT a characteristic of flail chest?

<p>Internal bleeding of over 200ml (C)</p> Signup and view all the answers

Fractured ribs can lead to inadequate ventilation due to shallow breathing.

<p>True (A)</p> Signup and view all the answers

What should be requested if a patient has a fractured sternum?

<p>clinician intervention/evaluation</p> Signup and view all the answers

What is a common cause of Tension Pneumothorax?

<p>Blunt trauma causing rib # (B)</p> Signup and view all the answers

A Tension Pneumothorax can be a life-threatening emergency.

<p>True (A)</p> Signup and view all the answers

What is the condition where blood accumulates in the thoracic cavity?

<p>Haemothorax</p> Signup and view all the answers

A condition that limits the heart's ability to pump due to fluid in the pericardial sac is called _____.

<p>Cardiac Tamponade</p> Signup and view all the answers

Which of these symptoms is NOT typically associated with a Tension Pneumothorax?

<p>Hypovolaemia (C)</p> Signup and view all the answers

Exposed chest is critical for assessing breathing in trauma patients.

<p>True (A)</p> Signup and view all the answers

What emergency intervention should be requested for a time-critical patient?

<p>APP, HEMS, Paramedic</p> Signup and view all the answers

Only ____ to ____ ml of blood is required to cause Cardiac Tamponade.

<p>20, 30</p> Signup and view all the answers

Match the following conditions with their definitions:

<p>Tension Pneumothorax = Air enters pleural space and cannot escape Haemothorax = Blood in the pleural cavity Cardiac Tamponade = Fluid compresses the heart Primary Survey = Initial assessment in trauma care</p> Signup and view all the answers

Which vital sign changes might you expect in a patient with Tension Pneumothorax?

<p>Hypotension (C)</p> Signup and view all the answers

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Study Notes

Chest Injuries Overview

  • Chest trauma is responsible for 25% of trauma deaths; contributes to an additional 50%.
  • Majority of serious chest injuries managed with chest drainage and resuscitation; only 10-15% require surgery.
  • Common causes of chest trauma include road traffic accidents (RTCs), industrial accidents, and sporting injuries.
  • Major complication from chest injuries is hypoxia, linked to ventilation impairment or hypovolemia.

Injury Potential

  • Structures potentially injured include heart, blood vessels, lungs, airways, soft tissue, bones, spinal cord, and nerves.
  • Rib injuries may indicate underlying damage to liver, kidneys, spleen, and other abdominal organs.
  • Attention to neck/spinal injuries is crucial in trauma cases.

Mechanism of Injury (MOI)

  • Blunt force injuries from RTCs, falls, and sports typically have an on-scene time of less than 20 minutes.
  • Penetrating trauma such as gunshot or stab wounds may have an on-scene time of minutes.

Signs and Symptoms

  • Indicators of chest injury include hypoxia, dyspnea, tachypnea, abnormal respiratory patterns, bruising, swelling, and pain.
  • Patients may demonstrate reduced consciousness and anxiety; assessment of time-critical situations is essential.

Types of Chest Injuries

  • Rib injuries: Common and may lead to shallow breathing and inadequate ventilation; can result in blood loss.
  • Fractured sternum occurs in 5% of blunt thoracic trauma cases; indicative of potential major injuries, with a high mortality rate.
  • Flail chest involves multiple rib fractures causing inadequate ventilation of the underlying lung.

Pneumothorax

  • Defined as air in the pleural space; can be spontaneous or trauma-induced.
  • Small pneumothorax may be benign if not progressing to tension pneumothorax; symptoms vary by size.
  • Tension pneumothorax is a life-threatening condition where trapped air increases thoracic pressure, leading to lung collapse and obstructive shock.

Open Pneumothorax

  • Resulting from penetrating trauma, it allows air to enter the pleural cavity, creating a "sucking chest wound."
  • Requires immediate medical intervention to restore normal breathing mechanics.

Haemothorax

  • Presence of blood in the pleural cavity typically due to penetrating injury or blunt trauma.
  • Can be time-critical, associated with hypoxia and hypovolemia, necessitating immediate treatment.

Cardiac Tamponade

  • Occurs when excessive fluid in the pericardial sac compresses the heart, limiting its pump capacity.
  • Often related to penetrating injuries; as little as 20-30ml of blood can induce tamponade, making it a life-threatening condition.

Assessment Protocol

  • Conduct primary survey assessing Circulation, Airway, Breathing, Disability, and Exposure (C ABCDE).
  • Identify catastrophic hemorrhages, airway or breathing issues, and other critical conditions demanding immediate advanced interventions.
  • Prioritize chest exposure during assessment to evaluate injury extent and treatment needs.

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