1009 thoracic trauma.ppt
TRANSCRIPT
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UNCLASSIFIED
UNCLASSIFIED
THORACIC TRAUMA
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UNCLASSIFIED
UNCLASSIFIED
REFERENCES
Pre Hospital Trauma Life Support (PHTLS)Military 7thed. 2011 ISBN 978-0-323-06503-0CHAPTER ! pp" #$%&&
Spe'ial Operatios For'es Mei'al Ha*oo+US Special Operatio! "o##ad 2ded. 2010 ISBN 978-0-16-08$7$$-8PART ,
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UNCLASSIFIED
UNCLASSIFIED
LEARNIN- O./ECTI0ES
PH1SIOLO-1 OF THE RESPIRATION
CHEST E2AMINATION
MECHANISMS OF CHEST IN/URIES
PATHO%PHISIOLO-1 AND TREATMENT
SIMPLE PNEUMOTHORA2
OPEN CHEST 3OUND
TENSION PNEUMOTHORA2
MASSI0E HEMOTHORA2
FLAIL CHEST
CARDIAC TAMPONADE
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UNCLASSIFIED
UNCLASSIFIED
CHEST TRAUMA IS THE
&rLEADIN- CAUSE OF TRAUMA DEATHS ON COM.AT E0EN IF THE INCIDENCE3AS REDUCED DUE TO THE USE OF .OD1 ARMOR
SOME CHEST IN/URIES ARE
IMMEDIATEL1 LIFE%THREATENIN-
$
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UNCLASSIFIED
UNCLASSIFIED
RESPIRATION
INHALATION
AIR 4 O#ENTERS LUN-S
E2HALATION
AIR 4 CO#MO0ES FROM LUN-S
5
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UNCLASSIFIED
UNCLASSIFIED
-AS E2CHAN-E
.LOOD FROM 0EINS
ARRI0ES THROU-H
PULMONAR1 ARTER1
THE -AS E2CHAN-E
TA5ES PLACE IN THE
AL0EOLUS
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UNCLASSIFIED
UNCLASSIFIED
RESPIRATOR1 D1SFUNCTION
FOLLO3IN- TRAUMA
ALTERED MO0EMENT OF THE CHEST AND DECREASE IN6
%&' ()'( (*(I+(B+' ,O) (S '"&(N'
B+OO/ '%%IN %O %&' +UNS
O2'%%IN %O %&' (+*'O+I
"O2B'IN )'+'(S'/ IN%O %&' (+*'O+I
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UNCLASSIFIED
Re'o7er8 positio
Pre7ious 9uieliesere to place the ca!alty ith the ired !ide do
IO% acilitate the 4ood !ide epa!io ad etilatio
I:ure sie up #ore recet !tdie! de#o!trated i!tead that
per!io i! the ir!t cocer ad IO% e!re the e!t per!io
to the o-ired !ide thi! oe ha! to e placed do
%o additioal co##et! aot hai4 ired !ide i! p are
+e!! che!t pai
%reat#et! are ea!ier to rea!!e!!
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UNCLASSIFIED
UNCLASSIFIED
CHEST E2AMINATION
INSPECT 4 CHEC5 THE .AC5 (IT IS A PART OF THECHEST INSPECTION)
PALPATE
AUSCULTATE ; MAR5 THE PMI
PERCUSS
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UNCLASSIFIED
UNCLASSIFIED
INSPECTION
THE INSPECTION OF THE CHEST STARTS AL3A1SFROM THE NEC5< THERE 1OU LOO5 FOR6
3OUNDS
TRACHEA DE0IATION
/U-ULAR 0EINS DISTENSION (/0D)
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STA. 3OUNDS -S3
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UNCLASSIFIED
UNCLASSIFIED
INSPECTION
THEN! 1OU HA0E TO INSPECT THE THORACICRE-ION" THERE 1OU LOO5 FOR
.ILATERAL RISE AND FALL OF THE CHEST
3OUNDS
3OUNDS IN HIDDEN PLACES (ARMPITS)
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UNCLASSIFIED
UNCLASSIFIED
INSPECTION
12
.ILATERAL RISE AND FALL OF THE CHEST3OUNDS3OUNDS IN HIDDEN PLACES
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UNCLASSIFIED
UNCLASSIFIED
Assess a treat t=e >ou
13
UNCLASSIFIED
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UNCLASSIFIED
UNCLASSIFIED
CHEC5 THE .AC5it= %#''
Remo7e t=e plu9er
: *u**les ii'ate release tesio
: NaCl flo>i9 isie ii'ates o
tesio ito t=e pleural 'a7it8
$3
UNCLASSIFIED
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UNCLASSIFIED $$
NEEDLE DECOMPRESSION
UNCLASSIFIED
NEED E DECOMPRESSION
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UNCLASSIFIED $5
NEEDLE DECOMPRESSION
EMER-ENC1 PROCEDURE TO RELIE0E THE TENSIONINSIDE THE PLEURAL CA0IT1
AN APPROPRIATE LAR-E NEEDLE IS NEEDED
(@%B -AU-E &"#G)
IT .U1S TIME
IT IS EAS1 TO PERFORM
NO%' it ta;e! 1-2hr! or a te!io
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UNCLASSIFIED
MIDCLA0ICULAR LINE
$6
NEEDLE DECOMPRESSION
@%t= INTERCOSTAL SPACE! NIPPLE
LE0EL! A.O0E THE RI.5th rib
6th rib
ANTERIOR A2ILLAR1 LINE (AAL)
#INTERCOSTAL SPACE!
A.O0E THE THIRD RI.
Le>is a9le
UNCLASSIFIED
AIR RELEASE S1STEM (ARS)
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UNCLASSIFIED $7
AIR RELEASE S1STEM (ARS)
UNCLASSIFIED
NEEDLE DECOMPRESSION
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UNCLASSIFIED
NEEDLE DECOMPRESSION
$8
UNCLASSIFIED
NEEDLE DECOMPRESSION HAARDS
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UNCLASSIFIED
NEEDLE DECOMPRESSION % HAARDS
$9
UNCLASSIFIED
MASSI0E HEMOTHORA2
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UNCLASSIFIED
MASSI0E HEMOTHORA2
COLLECTION OF LAR-E 0OLUMES OF.LOOD IN PLEURAL CA0IT1 ='("&
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UNCLASSIFIED 51
SI-NS OF MASSI0E HEMOTORA2
DIFFICULT AND RAPID .REATHIN-
SI-NS OF H1PO0OLEMIC SHOC5
TACH1CARDIA 3ITH 3EA5 PULSE
DECREASED .REATH SOUNDS
DULL PERCUSSION SOUND ON AFFECTED SITE
UNCLASSIFIED
HEMOTHORA2 FLUID LINE
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UNCLASSIFIED
THE AFFECTED SIDE OF THE CHEST
CAN .E ALMOST COMPLETEL1
FILLED 3ITH .LOOD
TO ASSESS THE SE0ERIT1 OF THE .LEEDIN- ON THE
FIELD IS RECOMMENDED TO DRA3 A LINE THAT
FOLLO3S THE DULLNESS ON THE CHEST AND
MAR5 THE TIME IN
ORDER TO CHEC5
THE PRO-RESSION
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HEMOTHORA2 FLUID LINE
&KK
#&K
UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST
MULTIPLE RI. FRACTURES
A.NORMAL MO0EMENT OF THEFRACTURED SE-MENT 3ITHREDUCTION OF 0ITAL CAPACIT1
LI5ELIHOOD OF SE0ERE UNDERL1IN-LUN- DAMA-E
SE0ERE H1PO2IA RESULTS DUE TOPAIN ASSOCIATED 3ITH INSPIRATION
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UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST
5$
STA.ILIE 4 O21-ENATE
UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST
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UNCLASSIFIED
FLAIL CHEST TREATMENT
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UNCLASSIFIED
FLAIL CHEST % TREATMENT
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STA.ILIE
CORRECT H1PO2IA
POSITIONIN-
INTERCOSTAL .LOC5S
PAIN 5ILLERS DRU-S 3ITHOUT
SIDE EFFECTS DEPRESSIN- THERESPIRATION