Blunt Chest Trauma

rib fracture

fracture to a single rib in one spot

rib fracture s/s

pain, tenderness, muscle spasms, no cardinal symptoms

rib fracture interventions

usually heal spontaneously, no splinting

rib fracture medications

intercostal nerve block, NSAIDs and opioids, PCA (morphine)

flail chest

3 or more adjacent rib fractures in 2 or more places

flail chest s/s

pain, SOB, dyspnea, cyanosis, tachycardia, hypotension, anxiety, decrease pulse ox, chest bruising

flail chest cardinal symptoms

paradoxical chest movement

what is paradoxical chest movement

the chest moves inward on inspiration and outward with expiration

flail chest intervention

intubation, TCB to promote lung expansion, mechanical ventilation, surgical stabilization, vitals, O2, fluids PRN

flail chest medication

pain control via IV, epidural, nerve block

what type of mechanical ventilation is used for flail chest

PEEP, double lumen tracheal tube

pulmonary contusion

bruising of lung causing excessive bleeding over time in and between alveoli/decel injuries

pulmonary contusion s/s

hypoxia, dyspnea, tachycardia, tachypnea, decreased breath sounds, crackles, wheezes

pulmonary contusion cardinal symptoms

hemoptysis, bloody frothy sputum

pulmonary contusion interventions

depends on severity and no medication