TCAR
Three inquiries to ask in trauma - ANS-what changed into the dose of electricity?
-wherein did it move?
-what accidents are probably?
2 q's to ask in GSW - ANScaliber
sort of gun
# of front/go out wounds
high/low speed
1st question to invite in any traumatic damage? - ANSwhat become the dose of power
concerned?
(was it excessive or low?)
what's the quality of a bullet? - ANSdiameter
aka diameter of a bullet - ANScaliber
what occurs to projectiles when they enter the frame - ANSprojectiles do not tour in a directly
line
don't forget temporary cavity wound
what must you remember about tissue a projectile enounters - ANStemporary cavitation
primary intention of GSW surgery - ANSusually damage restore & now not bullet elimination
-if superficial, it is able to migrate the surface with time
important thing to take into account approximately retained projectiles - ANSthey can also
migrate over time. Bullett migration might give an explanation for unexplained scientific
findings
(VP Cheney by chance shot his friend even as hunting in 2006. ICU and did amazing.
Moved to an inpatient unit. Had a silent MI bc a shot gun pellets migrated right into a canary
artery causing an infract. So had a MI but fibrinolytic now not the answer in this situation b/c
it became a "projectile embolus"
aka brestbone - ANSsternum
what attaches the ribs to the sternum - ANScartliage
what breaks thoracic bones - ANSsignificant pressure
-1-second ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the pressure aka "dose" of energy received
don't forget injury to inner systems b/c force
,ribs which are the most frequently broken - ANSribs four-nine b/c lengthy, thin, and poorly
protecte
it's far tougher to break a brief pencil (T1-2) and less difficult to interrupt a longer one
*ask what number of and where to apprehend the force worried
what is the significance of posterior rib fractures - ANSunusual course of harm
shorter stubby ribs
accurate muscle profection
**posterior rib fractures have quite a few force so want a excessive dose.
***PRF want lots of force so high dose of strength. Big pink flag for t-backbone harm
indication of c-backbone injury - ANSto injure c-backbone, you don't want a big power blow.
All it takes is shaking around.
C backbone versus t backbone fractures - ANSc-backbone doesn't need a big energy blow.
Just some shaking round
t-spine wishes a remarkable robust direct blow (not only a shock_
remedy for rib fractures - ANSlargely supportive nursing care like pulmonary bathroom
CXR and rib fractures - ANSsimple rib fractures are difficult to see on CXR and may be
typically overlooked
(half of of all rib fractures are not identified on the POI CXR)
perceive a previous rib fracture on CXR - ANSonce healed, rib fractures shape bony
callouses and turn out to be greater seen on CXR
how to tell a pt has a pneumonia from a CXR - ANSdark spot that isn't always same to the
other facet
consider if a pt has a lower rib fracture - ANSliver & spleen damage
acts like BBQ/marshmellow skewers
how excessive does the diaphragm upward push on suggestion - ANSlevel of 4th ICS
hazard of rib fractures - ANScan puncture liver, spleen,, diaphragm
pop lungs
+2 adjoining rib fractures - ANSflail chest
free floating sternum - ANSflail chest
definition of flail chest - ANS+2 adjacent rib fracture
free floating sternum
why is flail chest a trouble - ANSb/c respiration is a mechanical method
,paradoxical chest movements - ANSin flail chest
s/s of flail chest - ANSparadoxical chest wall motion
wherein at the tissue oxygenation cascade is thoracic cage fractures a hassle -
ANSventilation
parameters to assess air flow - ANSETCO2, PaCO2, medical assessment
what are considered "outstanding vessels" - ANS
thorax - ANS
what sort of injuries arise when the lungs are subjected to pressure? - ANSbruise =
contusion
tear = lacerations
pop = punctures
inhalation harm
bruise on the lungs - ANSpulmonary contusion
reasons of pulmonary contusions - ANShigh velocity blunt or penetrating injury
what takes place to the lungs in pulmonary contusions - ANSbig boggy bruise on the lungs
diffusion issues
when it becomes contused & edematous, it will become tough for oxygen to move from the
alveoli into the capillaries
in which on the tissue oxygenation cascade do pulmonary contusions purpose their troubles
- ANSdiffusion
all contusions over the years - ANSall contusions "blossom" over time. The total volume of
the harm isn't to start with obvious
vital thing to recall while you are comparing a patient for pulmonary contusions - ANS70% of
pulmonary contusions aren't preliminary on the preliminary CXR
what must you display while a pt has trauma to the throax - ANSclosely monitor for
pulmonary contustiobs = 70% now not present at the preliminary CXR and "blossom" over
the years
-display for progress e deterioration in hours/days submit harm
*may look good enough in ER
excellent parameter of serial monitoring for pt's who have danger factors for pulmonary
contusions - ANSanticipate "blossoming" over time b/c 70% of pulmonary contusions aren't
present on the preliminary CXR
P:F ratio
, hassle of the usage of CXR as a definitive clinical dx device - ANSCXR might also lag at the
back of scientific popularity
*b/c 70% of pulmonary contusions are not present on preliminary CXR. They "blossom" over
time
tear in lung tissue - ANSpulmonary laceration
problem of pulmonary lacerations - ANSrisk of big hemothoax b/c the ones vessels are very
vascular
simple v. Tension v. Open v. Closed. V. Hemothorax v. Hemopneumothorax - ANS
what's a simple pneumothorax - ANSany air that enters the pleural hollow space also can
depart on the same rate. Lungs deflated however no boom in intrathroacic pressure. Air
in/out exits on the equal fee. Pt might be able to tolerate a easy pneumothraox
causes a hassle on the ventilation factor at the tissue oxygen cascade
intrathroacic pressure in easy pneumothorax - ANSair that enters the pleural cavity leaves
on the identical fee
lungs are deflated but no boom in strain
air in/out on the identical fee
wherein is the trouble within the tissue oxygenation cascade in easy pneumothroax -
ANSventilation
what happens in penumothorax - ANSlungs are collapsed/deflated
aire enters space among the visceral & parietal
two layers of the lungs - ANSvisceral & parietal
Q - in a pneumothorax, no ligaments connect the lung to the wall. So what holds it up? -
ANSA - a skinny layer of pleural fluid & bad stress. The liquid facilitates it stick like how a
spilled liquid bureaucracy a seal among a glass and a clean table top
difference between a simple and tension pneumo - ANS
aka chest tube - ANSchest thoacotomy
cause of using a chest tube in easy pneumothorax - ANSto allow for negative strain to
reestablish .
Anxiety pnumothorax - ANSair enters beneath stress however would not exit at the same
price. = accumulation of air below pressure
instance of tension pneumothorax - ANSlike the use of a bicycle pump to position
increasingly air into the lungs over the years. No break out
*stress manner no lung function on the facet of the damage and compromises characteristic
on the un injured coronary heart and splendid vessel compression
Three inquiries to ask in trauma - ANS-what changed into the dose of electricity?
-wherein did it move?
-what accidents are probably?
2 q's to ask in GSW - ANScaliber
sort of gun
# of front/go out wounds
high/low speed
1st question to invite in any traumatic damage? - ANSwhat become the dose of power
concerned?
(was it excessive or low?)
what's the quality of a bullet? - ANSdiameter
aka diameter of a bullet - ANScaliber
what occurs to projectiles when they enter the frame - ANSprojectiles do not tour in a directly
line
don't forget temporary cavity wound
what must you remember about tissue a projectile enounters - ANStemporary cavitation
primary intention of GSW surgery - ANSusually damage restore & now not bullet elimination
-if superficial, it is able to migrate the surface with time
important thing to take into account approximately retained projectiles - ANSthey can also
migrate over time. Bullett migration might give an explanation for unexplained scientific
findings
(VP Cheney by chance shot his friend even as hunting in 2006. ICU and did amazing.
Moved to an inpatient unit. Had a silent MI bc a shot gun pellets migrated right into a canary
artery causing an infract. So had a MI but fibrinolytic now not the answer in this situation b/c
it became a "projectile embolus"
aka brestbone - ANSsternum
what attaches the ribs to the sternum - ANScartliage
what breaks thoracic bones - ANSsignificant pressure
-1-second ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the pressure aka "dose" of energy received
don't forget injury to inner systems b/c force
,ribs which are the most frequently broken - ANSribs four-nine b/c lengthy, thin, and poorly
protecte
it's far tougher to break a brief pencil (T1-2) and less difficult to interrupt a longer one
*ask what number of and where to apprehend the force worried
what is the significance of posterior rib fractures - ANSunusual course of harm
shorter stubby ribs
accurate muscle profection
**posterior rib fractures have quite a few force so want a excessive dose.
***PRF want lots of force so high dose of strength. Big pink flag for t-backbone harm
indication of c-backbone injury - ANSto injure c-backbone, you don't want a big power blow.
All it takes is shaking around.
C backbone versus t backbone fractures - ANSc-backbone doesn't need a big energy blow.
Just some shaking round
t-spine wishes a remarkable robust direct blow (not only a shock_
remedy for rib fractures - ANSlargely supportive nursing care like pulmonary bathroom
CXR and rib fractures - ANSsimple rib fractures are difficult to see on CXR and may be
typically overlooked
(half of of all rib fractures are not identified on the POI CXR)
perceive a previous rib fracture on CXR - ANSonce healed, rib fractures shape bony
callouses and turn out to be greater seen on CXR
how to tell a pt has a pneumonia from a CXR - ANSdark spot that isn't always same to the
other facet
consider if a pt has a lower rib fracture - ANSliver & spleen damage
acts like BBQ/marshmellow skewers
how excessive does the diaphragm upward push on suggestion - ANSlevel of 4th ICS
hazard of rib fractures - ANScan puncture liver, spleen,, diaphragm
pop lungs
+2 adjoining rib fractures - ANSflail chest
free floating sternum - ANSflail chest
definition of flail chest - ANS+2 adjacent rib fracture
free floating sternum
why is flail chest a trouble - ANSb/c respiration is a mechanical method
,paradoxical chest movements - ANSin flail chest
s/s of flail chest - ANSparadoxical chest wall motion
wherein at the tissue oxygenation cascade is thoracic cage fractures a hassle -
ANSventilation
parameters to assess air flow - ANSETCO2, PaCO2, medical assessment
what are considered "outstanding vessels" - ANS
thorax - ANS
what sort of injuries arise when the lungs are subjected to pressure? - ANSbruise =
contusion
tear = lacerations
pop = punctures
inhalation harm
bruise on the lungs - ANSpulmonary contusion
reasons of pulmonary contusions - ANShigh velocity blunt or penetrating injury
what takes place to the lungs in pulmonary contusions - ANSbig boggy bruise on the lungs
diffusion issues
when it becomes contused & edematous, it will become tough for oxygen to move from the
alveoli into the capillaries
in which on the tissue oxygenation cascade do pulmonary contusions purpose their troubles
- ANSdiffusion
all contusions over the years - ANSall contusions "blossom" over time. The total volume of
the harm isn't to start with obvious
vital thing to recall while you are comparing a patient for pulmonary contusions - ANS70% of
pulmonary contusions aren't preliminary on the preliminary CXR
what must you display while a pt has trauma to the throax - ANSclosely monitor for
pulmonary contustiobs = 70% now not present at the preliminary CXR and "blossom" over
the years
-display for progress e deterioration in hours/days submit harm
*may look good enough in ER
excellent parameter of serial monitoring for pt's who have danger factors for pulmonary
contusions - ANSanticipate "blossoming" over time b/c 70% of pulmonary contusions aren't
present on the preliminary CXR
P:F ratio
, hassle of the usage of CXR as a definitive clinical dx device - ANSCXR might also lag at the
back of scientific popularity
*b/c 70% of pulmonary contusions are not present on preliminary CXR. They "blossom" over
time
tear in lung tissue - ANSpulmonary laceration
problem of pulmonary lacerations - ANSrisk of big hemothoax b/c the ones vessels are very
vascular
simple v. Tension v. Open v. Closed. V. Hemothorax v. Hemopneumothorax - ANS
what's a simple pneumothorax - ANSany air that enters the pleural hollow space also can
depart on the same rate. Lungs deflated however no boom in intrathroacic pressure. Air
in/out exits on the equal fee. Pt might be able to tolerate a easy pneumothraox
causes a hassle on the ventilation factor at the tissue oxygen cascade
intrathroacic pressure in easy pneumothorax - ANSair that enters the pleural cavity leaves
on the identical fee
lungs are deflated but no boom in strain
air in/out on the identical fee
wherein is the trouble within the tissue oxygenation cascade in easy pneumothroax -
ANSventilation
what happens in penumothorax - ANSlungs are collapsed/deflated
aire enters space among the visceral & parietal
two layers of the lungs - ANSvisceral & parietal
Q - in a pneumothorax, no ligaments connect the lung to the wall. So what holds it up? -
ANSA - a skinny layer of pleural fluid & bad stress. The liquid facilitates it stick like how a
spilled liquid bureaucracy a seal among a glass and a clean table top
difference between a simple and tension pneumo - ANS
aka chest tube - ANSchest thoacotomy
cause of using a chest tube in easy pneumothorax - ANSto allow for negative strain to
reestablish .
Anxiety pnumothorax - ANSair enters beneath stress however would not exit at the same
price. = accumulation of air below pressure
instance of tension pneumothorax - ANSlike the use of a bicycle pump to position
increasingly air into the lungs over the years. No break out
*stress manner no lung function on the facet of the damage and compromises characteristic
on the un injured coronary heart and splendid vessel compression
