Chest Trauma Review Flashcards

Flashcards covering key pulmonary contusion, pneumothorax, tension pneumothorax, rib fracture, flail chest, and hemothorax concepts from lecture notes.

What is a pulmonary contusion?

Bruising/injury of the lung tissue that makes it harder to ventilate.

Can symptoms of a pulmonary contusion be delayed?

Yes.

What positioning is used for a patient with a pulmonary contusion?

Moderate-Fowler's and side-lying with the GOOD lung down.

What oxygen therapy and ventilatory interventions may be used for a pulmonary contusion?

High-flow nasal cannula for high FiO₂, noninvasive positive-pressure ventilation, intubation for severe distress, and IV fluids.

What complications should be monitored for in a patient with a pulmonary contusion?

Pneumonia and respiratory failure.

What is a pneumothorax?

Air enters the pleural space.

What are the signs and symptoms of a pneumothorax? -10

1. Sudden/sharp pain,

2. pleuritic pain,

3. dyspnea,

4. absent breath sounds on affected side,

5. hypoxia,

6. cyanosis,

7. anxiety,

8. accessory muscle use,

9. asymmetrical chest expansion

10. subcutaneous emphysema.

What happens during a tension pneumothorax?

A one-way valve effect occurs: air enters during inspiration but cannot escape during exhalation, causing continuous pressure buildup.

In which direction does the trachea deviate during a tension pneumothorax?

AWAY from the affected side.

What is the emergency treatment for a tension pneumothorax?

Immediate decompression via emergency needle decompression or thoracentesis, followed by a chest tube for definitive drainage.

What needle size and location are used for emergency needle decompression?

Large-bore $14\text{--}16\text{ gauge}$ needle at the 2nd intercostal space at the midclavicular line.

What rib-fracture findings indicate a poor prognosis?

1st or 2nd rib fractures, flail chest, 7 or more fractured ribs, and expired volumes $< 15\text{ mL/kg}$.

What is the main treatment focus for rib fractures?

Pain control (using opioids, NSAIDs, intercostal nerve block, epidural analgesia, or PCA), because the ribs can heal on their own.

Why should the nurse NEVER tightly splint or tape the chest wall for rib fractures?

Because it restricts chest expansion.

What fracture pattern creates a flail chest?

3 or more adjacent ribs fractured in 2 places, creating an unstable, free-floating chest-wall segment.

How does the flail chest segment move during inspiration and expiration?

During inspiration the flail segment moves INWARD, and during expiration it moves OUTWARD (paradoxical chest-wall movement).

What findings can occur with flail chest 8

Paradoxical chest wall movement

unequal chest expansion

dyspnea

tachypnea

hypotension

cyanosis

anxiety

chest pain

What differentiates a simple hemothorax from a massive hemothorax?

A simple hemothorax is less than $1,000\text{ mL}$ of blood, whereas a massive hemothorax is greater than $1,000\text{ mL}$ of blood.

When is an open thoracotomy indicated for a hemothorax?

When initial blood loss is $> 1,000\text{ mL}$, OR there is continued bleeding of $150\text{--}200\text{ mL/hr}$ for $3\text{--}4\text{ hours}$.

What diagnostic tests are used to evaluate a hemothorax? 6

Chest x-ray, ultrasound, CT, ABGs, CBC and thoracentesis.

Q: What are the risk factors/causes of pneumothorax?

A: Blunt chest trauma, penetrating chest wound, spontaneous lung-bleb rupture, medical procedures, closed/occluded chest tube, and COPD.

What diagnostics are used for pneumothorax?

A: Chest X-ray and CT.

What assessments are important for pulmonary contusion?
.

A: Monitor respiratory status, lung sounds, and SaO₂

What diagnostics/labs are relevant to pulmonary contusion?

A: SaO₂ is specifically listed; ABGs are also included in the general chest-trauma diagnostics.

What are the signs and symptoms of hemothorax? -10

1. Dyspnea,

2. tachypnea,

3. asymmetrical chest movement,

4. absent breath sounds,

5. hemodynamic instability.

6. Cyanosis

7. Hypoxia

8. Tachycardia

9. Respiratory distress

10. anxiety

: What are the causes of tension pneumothorax?

A: Severe blunt chest trauma, MVC, and an occluded/closed chest tube.

What diagnostic is listed for tension pneumothorax?

A: Chest X-ray

What are the signs and symptoms of rib fractures?

A: Chest pain, pain with breathing, and shallow respirations.

What do you assess for flail chest, this include labs and Dx

VS

Sao2

Lung sounds

skin color

pulmonary funciton

cap refill

abgs

ches xray

i & O

S/S of pulmonary contusion

1. Dyspnea

2. Tachypnea

3. Tachycardia

4. hypoxemia

5. INC work of breath

6. Dry cough

7. Chest Bruising

8. Dec breath sounds

9. crackles

10. wheeze

11. dullness to percussion