2024 ATLS Module 4 - Thoracic Trauma Latest Questions With Complete Grade A Answers
- What percent of blunt chest injuries require operation?
Answer: <10%
- What % of penetrating chest trauma requires surgery
Answer: 15-30%
- Goal of early intervention of thoracic trauma
Answer: correct hypoxia
- Assessment of life-threatening breathing problems
Answer:
Look: Neck veins, breathing, chest wall movement
Listen: Breath sounds, changes in breathing pattern
Feel: Tenderness, crepitus, defects
*Maintain C-Spine motion restriction*
- Life threatening thoracic injuries
Answer: A-Airway
-Airway obstruction -Tracheobronchial tree injury
B-breathing -Tension pneumo -Open Pneumo -Massive Hemothorax
C-circulation -Massive Hemothorax -Cardiac Tamponade -Traumatic circulatory arrest
6. Airway obstruction: Cause
Answer: Swelling ,bleeding, or vomitus is aspirated into the airway, interfering with gas exchange.
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Common Mechanisms:
-Laryngeal Injury -Posterior dislocation of clavicular head -Penetrating trauma to neck or chest
- Tracheobronchial tree injury
Answer: rare, severe injury. Most its die at scene, otherwise high mortality at hospital.
from:
-associated injuries -inadequate airway -tension pneumothorax -pneumopericardium
*intubation can make this worse
- Tracheobronchial tree injury findings
Answer:
Signs: hemoptysis, cervical subcuta neous emphysema, crepitus in the chest,
incomplete expansion of the lung, bubbling in chest tube water seal chamber
From: deceleration in blunt trauma, direct laceration, tearing, transfer of kinetic injury in penetrating trauma; severe injury at air fluid interfaces in blast injuries.
Diagnosed by bronchoscopy
Needs immediate surgical consult, intubation of these patients is often difficult
*Intubation cause or worsen an injury to the trachea or proximal bronchi.
- Tension Pneumothorax
Answer: a type of pneumothorax in which air that enters the chest cavity is
prevented from escaping. Mediastinum is shifted, decreasing venous return and compressing opposite lung.
MCC: Mechanical positive pressure ventilation in patients with visceral pleural injury; complication of simple pneumothorax; trauma to chest wall
Signs and symptoms: Air hunger, tachypnea, respiratory distress, tachycardia,
hypotension, tracheal deviation, unilateral breath sounds, neck vein distention, cyanosis, chest pain
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