Chest trauma management gk

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Chest trauma management gk

  1. 1. Chest Trauma Management
  2. 2. Needle ThoracocentesisIndications: Primary spontaneous pneumothorax Tension pneumothoraxRelative contraindications: Thoracocentesis should be only be considered in consultation with a senior emergency physician in the following: Spontaneous pneumothorax in patients with underlying lung disease Traumatic pneumothorax without tension 2
  3. 3. CMAST 3
  4. 4. ProcedurePlace patient on continuous cardiac monitoring and pulse oximetryPatient positionPlace trauma patient in a head-up, supine positionAll other patients should be placed in 45-degree, sitting positionPalpate landmark (the upper border of the 3rd rib in the midclavicular line) andantiseptically prepare the areaAttach a 5ml syringe to the catheter devicePuncture the skin at the level of above landmarkCarefully insert the needle at a slightly downwards angle into the pleural space whileaspirating the syringeIn tension pneumothorax, often you will hear a pop or feel a change of resistanceWithdraw the needle while gently advancing the cannula downwards into positionSecure cannula/CVC with tape/tegadermAttach 3 way tap and 50ml syringeDrain until no further drainage or to a maximum of 30ml/kg (max 2.5l) CMAST 4
  5. 5. Chest tube insertionChest tubes are used to treat conditions that cancause a lung to collapse. Some of these conditionsare: After surgery or trauma in the chest Air leaks from inside the lung into the chest (pneumothorax) Fluid buildup in the chest (called a pleural effusion) due to bleeding into the chest, buildup of fatty fluid, abscess or pus buildup in the lung or the chest, or heart failure CMAST 5
  6. 6. CMAST 6
  7. 7. CMAST 7
  8. 8. PericardiocentesisEmergent pericardiocentesis: The indication foremergent pericardiocentesis is the presence oflife-threatening hemodynamic changes in apatient with suspected cardiac tamponade.Nonemergent pericardiocentesis: The aspirationof pericardial fluid in hemodynamically stablepatients for diagnostic, palliative, or prophylacticreasons, performed under ultrasonography,computerized tomography, or fluoroscopicvisualization. CMAST 8
  9. 9. CMAST 9
  10. 10. CMAST 10

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