This document discusses the management of chest trauma. It describes various types of chest injuries including rib fractures, flail chest, pneumothorax, hemothorax, and tension pneumothorax. For each injury, it outlines the signs and symptoms and recommended treatment approaches. It emphasizes the importance of assessing airway, breathing, and circulation when treating chest trauma patients. It also provides details on procedures for needle chest decompression to treat tension pneumothorax.
Hemopneumothorax, or haemopneumothorax is the condition of having air in the chest cavity (pneumothorax) and blood in the chest cavity (hemothorax). A hemothorax, pneumothorax, or the combination of both can occur due to an injury to the lung or chest.
CHEST INJURY- BLUNT/ Trauma Surgery
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on CHEST INJURY- BLUNT- an important topic in trauma. Even the blunt chest trauma can turn into penetrating one because of jagged edges of the broken ribs. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about pathophysiology, clinical approach, symptoms, signs, investigations, different individual types of Chest injuries and management of all the varieties of Chest injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of chest injury and should also be able to institute immediate lifesaving treatment to the patients if there is a need. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Hemopneumothorax, or haemopneumothorax is the condition of having air in the chest cavity (pneumothorax) and blood in the chest cavity (hemothorax). A hemothorax, pneumothorax, or the combination of both can occur due to an injury to the lung or chest.
CHEST INJURY- BLUNT/ Trauma Surgery
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on CHEST INJURY- BLUNT- an important topic in trauma. Even the blunt chest trauma can turn into penetrating one because of jagged edges of the broken ribs. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about pathophysiology, clinical approach, symptoms, signs, investigations, different individual types of Chest injuries and management of all the varieties of Chest injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of chest injury and should also be able to institute immediate lifesaving treatment to the patients if there is a need. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
Guidelines and procedures of triage in the prehospital setting as stated in BLS 2007, v. 2.0 and Field Trauma Triage and Air Ambulance Utilization Standards Training Bulletin, (2014, issue 113, v. 1.0). Applies to all paramedics in Ontario.
Blunt chest trauma with surgical emphysema - A case reportHriday Ranjan Roy
This patient was presented to us with severe life threatening conditions. We treated him at ICU, Rangpur Medical College Hospital and he was completely cured. Later a case presentation was done at Seminar Room of the same institute.
chest trauma is one of the leading cause of death in poly trauma patients. ER doctor should be aware of how to suspect and how to deal with life threatening conditions resulting from chest trauma
CPCR Basic Life Support by Midland HealthcareAbhishek Singh
1. James Elam -first to experimentally demonstrate CPR
2. Dr. Peter Safar- brought to light effective procedures putting them together into what he called “the ABCs”
3. Claude Beck- Internal defibrillator
4. Paul Zoll- AC External defibrillator
5. Bernard Lown- DC external defibrillator
6. Foundation of successful ACLS is good BLS
For Help Visit: https://midlandhealthcare.org/
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
6. Penetrating trauma.Penetrating trauma.
– GSW or stab woundsGSW or stab wounds
– Concentrates forces overConcentrates forces over
smaller areasmaller area
– Bullet trajectoriesBullet trajectories
unpredictableunpredictable
Determine the MOIDetermine the MOI
7. Determine the MOI cont.Determine the MOI cont.
Blunt trauma.Blunt trauma.
– Force distributed over largerForce distributed over larger
areaarea
– Visceral injuries occur from:Visceral injuries occur from:
• DecelerationDeceleration
• CompressionCompression
• Sheering forcesSheering forces
8. Assess the CasualtyAssess the Casualty
Identify signs and symptoms:Identify signs and symptoms:
Assess mental status (AVPU)Assess mental status (AVPU)
Assess the airwayAssess the airway
Assess the breathingAssess the breathing
Assess the circulationAssess the circulation
15. Assess the Chest WallAssess the Chest Wall
Compare bothCompare both
sides of thesides of the
chest at thechest at the
same time whensame time when
assessing forassessing for
asymmetry.asymmetry.
16. Chest PhysiologyChest Physiology
Chest normally has negative pressure.Chest normally has negative pressure.
Penetrating wound creates a positivePenetrating wound creates a positive
pressure in chest cavity.pressure in chest cavity.
Air will enter the easiest route. If aAir will enter the easiest route. If a
hole in the chest is smaller than 2/3hole in the chest is smaller than 2/3
the size of the trachea, air will enterthe size of the trachea, air will enter
through the trachea preferentially andthrough the trachea preferentially and
not through the hole in the chest.not through the hole in the chest.
19. Rib FractureRib Fracture
11.. Most common chest wall injury fromMost common chest wall injury from
direct traumadirect trauma
2.More common in adults than2.More common in adults than
childrenchildren
3.Especially common in elderly3.Especially common in elderly
4.Most commonly 5th - 9th ribs4.Most commonly 5th - 9th ribs
20. Rib FractureRib Fracture
Rib Fracture Fractures of 1st and 2ndRib Fracture Fractures of 1st and 2nd
second require high forcesecond require high force
Frequently have injury to aorta orFrequently have injury to aorta or
bronchibronchi
Occur in 90% of patients withOccur in 90% of patients with
tracheobronchial rupturetracheobronchial rupture
21. Rib FractureRib Fracture
Rib Fracture Fractures of 10 to 12thRib Fracture Fractures of 10 to 12th
ribs can cause damage to underlyingribs can cause damage to underlying
abdominal solid organs:-abdominal solid organs:-
1 Liver1 Liver
2.Spleen2.Spleen
3.Kidneys3.Kidneys
22. Rib FractureRib Fracture
Assessment Findings:-Assessment Findings:-
1.Localized pain, tenderness1.Localized pain, tenderness
2.Increases on palpation or when2.Increases on palpation or when
patient:patient:
Coughs ,Moves , Breathes deeplyCoughs ,Moves , Breathes deeply
3.Splinted Respirations3.Splinted Respirations
23. Rib FractureRib Fracture ManagementManagement
High concentration O2High concentration O2
Positive pressure ventilationPositive pressure ventilation
Encourage pt to breath deeplyEncourage pt to breath deeply
Analgesics for isolated traumaAnalgesics for isolated trauma
Non-circumferential splintingNon-circumferential splinting
24. Flail ChestFlail Chest
The breaking of 2The breaking of 2
or more ribs in 2or more ribs in 2
or more placesor more places
26. S/S of Flail ChestS/S of Flail Chest
Shortness of BreathShortness of Breath
Paradoxical MovementParadoxical Movement
Bruising/SwellingBruising/Swelling
Crepitus( Grinding of bone ends onCrepitus( Grinding of bone ends on
palpationpalpation
27. Treatment of Flail ChestTreatment of Flail Chest
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
High Flow oxygenHigh Flow oxygen
Monitor Patient for signs ofMonitor Patient for signs of
Pneumothorax or TensionPneumothorax or Tension
PneumothoraxPneumothorax
Use Gloved hand as splint till bulkyUse Gloved hand as splint till bulky
dressing can be put on patientdressing can be put on patient
28. Bulky Dressing for splint of FlailBulky Dressing for splint of Flail
ChestChest
Use Trauma bandageUse Trauma bandage
and Triangularand Triangular
Bandages to splint ribs.Bandages to splint ribs.
29. Simple/Closed PneumothoraxSimple/Closed Pneumothorax
Opening in lungOpening in lung
tissue that leaks airtissue that leaks air
into chest cavityinto chest cavity
Blunt trauma isBlunt trauma is
main causemain cause
May beMay be
spontaneousspontaneous
Usually selfUsually self
correctingcorrecting
30. S/S of Simple/Closed PneumothoraxS/S of Simple/Closed Pneumothorax
Chest PainChest Pain
DyspneaDyspnea
TachypneaTachypnea
Decreased Breath Sounds onDecreased Breath Sounds on
Affected SideAffected Side
31. Treatment for Simple/ClosedTreatment for Simple/Closed
PneumothoraxPneumothorax
ABC’s with C-spine controlABC’s with C-spine control
Airway Assistance as neededAirway Assistance as needed
If not contraindicated transportIf not contraindicated transport
in semi-sitting positionin semi-sitting position
Provide supportive careProvide supportive care
32. Open PneumothoraxOpen Pneumothorax
Opening in chestOpening in chest
cavity that allowscavity that allows
air to enter pleuralair to enter pleural
cavitycavity
Causes the lung toCauses the lung to
collapse due tocollapse due to
increased pressureincreased pressure
in pleural cavityin pleural cavity
38. S/S of Open PneumothoraxS/S of Open Pneumothorax
DyspneaDyspnea
Sudden sharp painSudden sharp pain
Subcutaneous EmphysemaSubcutaneous Emphysema
Decreased lung sounds on affectedDecreased lung sounds on affected
sideside
Red Bubbles on Exhalation fromRed Bubbles on Exhalation from
woundwound
39. Subcutaneous EmphysemaSubcutaneous Emphysema
Air collects in subcutaneous fatAir collects in subcutaneous fat
from pressure of air in pleuralfrom pressure of air in pleural
cavitycavity
Feels like rice crispies or bubbleFeels like rice crispies or bubble
wrapwrap
Can be seen from neck to groinCan be seen from neck to groin
areaarea
42. Open PneumothoraxOpen Pneumothorax Management:Management:
Ensure an open airwayEnsure an open airway
Close the chest wall defect, bothClose the chest wall defect, both
entrance and exit with an occlusiveentrance and exit with an occlusive
dressing, petrolatum gauze or Ashermandressing, petrolatum gauze or Asherman
Chest SealChest Seal®®
Place the casualty in the sitting positionPlace the casualty in the sitting position
Monitor respirations after an occlusiveMonitor respirations after an occlusive
dressing is applieddressing is applied
43. Open PneumothoraxOpen Pneumothorax
Petroleum Gauze can also be used to sealPetroleum Gauze can also be used to seal
a sucking chest wound.a sucking chest wound.
45. Tension PneumothoraxTension Pneumothorax
Air builds in pleural space withAir builds in pleural space with
no where for the air to escapeno where for the air to escape
Results in collapse of lung onResults in collapse of lung on
affected side that results inaffected side that results in
pressure on mediastium,thepressure on mediastium,the
other lung, and great vesselsother lung, and great vessels
49. S/S of Tension PneumothoraxS/S of Tension Pneumothorax
Anxiety/RestlessnessAnxiety/Restlessness
Severe DyspneaSevere Dyspnea
Absent Breath sounds on affectedAbsent Breath sounds on affected
sideside
TachypneaTachypnea
TachycardiaTachycardia
Poor ColorPoor Color
50. S/S of Tension Pneumothorax cont.S/S of Tension Pneumothorax cont.
Accessory Muscle UseAccessory Muscle Use
JVDJVD
Narrowing Pulse PressuresNarrowing Pulse Pressures
HypotensionHypotension
Tracheal DeviationTracheal Deviation
(late if seen at all)(late if seen at all)
53. Tension PneumothoraxTension Pneumothorax
Management:Management:
Ensure an open airwayEnsure an open airway
Decompress the affected sideDecompress the affected side
Indications:Indications:
– Penetrating chest wound withPenetrating chest wound with
progressive respiratory distressprogressive respiratory distress
54. Needle Chest DecompressionNeedle Chest Decompression
Procedure:Procedure:
Identify the second ICS on theIdentify the second ICS on the
anterior chest wall, MCL:anterior chest wall, MCL:
55. Needle Chest DecompressionNeedle Chest Decompression
If a tension pneumothorax is present,If a tension pneumothorax is present,
a" hiss of air” may bea" hiss of air” may be
heard escaping from theheard escaping from the
chest cavity.chest cavity.
Remove the needle, leave the catheterRemove the needle, leave the catheter
in place.in place.
56. Needle Chest DecompressionNeedle Chest Decompression
Insert a 14 ga. Catheter atInsert a 14 ga. Catheter at
aa
9090°° angle over the topangle over the top
ofof
the 3the 3rdrd
rib, into the 2rib, into the 2ndnd
ICSICS
at the MCL.at the MCL.
Needle should be longNeedle should be long
enough to enter theenough to enter the
57. HemothoraxHemothorax
Occurs when pleural space fillsOccurs when pleural space fills
with blood .Usually occurs due towith blood .Usually occurs due to
lacerated blood vessel in thoraxlacerated blood vessel in thorax
As blood increases, it puts pressureAs blood increases, it puts pressure
on heart and other vessels in cheston heart and other vessels in chest
cavitycavity
Each Lung can hold 1.5 liters ofEach Lung can hold 1.5 liters of
bloodblood
62. S/S of HemothoraxS/S of Hemothorax
Anxiety/RestlessnessAnxiety/Restlessness
TachypneaTachypnea
Signs of ShockSigns of Shock
Frothy, Bloody SputumFrothy, Bloody Sputum
Diminished Breath Sounds onDiminished Breath Sounds on
Affected SideAffected Side
TachycardiaTachycardia
63. Treatment of HaemothoraxTreatment of Haemothorax
Establish airway HighEstablish airway High
concentration O2concentration O2
Drainage by chest tubeDrainage by chest tube
ThoracotomyThoracotomy
66. Complications of Chest DrainageComplications of Chest Drainage
tubetube
HemorrhageHemorrhage
Damage to intercostal vesselsDamage to intercostal vessels
and nervesand nerves
Lung and mediastinal injuryLung and mediastinal injury
InfectionInfection
67. Indications of thoracotomyIndications of thoracotomy
In pneumothoraxIn pneumothorax
1.continuing air leak for more1.continuing air leak for more
than 7 daysthan 7 days
2.massive air leak suggesting2.massive air leak suggesting
major air -way injurymajor air -way injury
3.associated lung contusions3.associated lung contusions
68. Indications of thoracotomyIndications of thoracotomy
In haemothoraxIn haemothorax
1. massive bleeding more than 11. massive bleeding more than 1
Ltr.statLtr.stat
2. continuing bleeding more2. continuing bleeding more
than 200 Ml/hr over 3 hrsthan 200 Ml/hr over 3 hrs
3.brisk bleeding more than 1003.brisk bleeding more than 100
Ml every 15 min for 1 hrMl every 15 min for 1 hr
69. Pericardial TamponadePericardial Tamponade
Blood and fluidsBlood and fluids
leak into theleak into the
pericardial sacpericardial sac
which surroundswhich surrounds
the heart.the heart.
As the pericardialAs the pericardial
sac fills, it causessac fills, it causes
the sac to expandthe sac to expand
until it cannotuntil it cannot
expand anymore
pericardial sac
70. Pericardial TamponadePericardial Tamponade
Once the pericardialOnce the pericardial
sac can’t expandsac can’t expand
anymore, the fluidanymore, the fluid
starts puttingstarts putting
pressure on the heartpressure on the heart
Now the heart can’tNow the heart can’t
fully expand and can’tfully expand and can’t
pump effectively.pump effectively.
71. Pericardial TamponadePericardial Tamponade
Once the pericardialOnce the pericardial
sac can’t expandsac can’t expand
anymore, the fluidanymore, the fluid
starts puttingstarts putting
pressure on the heartpressure on the heart
Now the heart can’tNow the heart can’t
fully expand and can’tfully expand and can’t
pump effectively.pump effectively.
74. PericardiocentesisPericardiocentesis
Using aseptic technique, Insert at leastUsing aseptic technique, Insert at least
3” needle at the angle of the Xiphoid3” needle at the angle of the Xiphoid
Cartilage at the 7Cartilage at the 7thth
ribrib
Advance needle at 45 degree towardsAdvance needle at 45 degree towards
the clavicle while aspirating syringe tillthe clavicle while aspirating syringe till
blood return is seenblood return is seen
Continue to Aspirate till syringe is fullContinue to Aspirate till syringe is full
then discard blood and attempt againthen discard blood and attempt again
till signs of no more bloodtill signs of no more blood
75. Traumatic Aortic RuptureTraumatic Aortic Rupture
The heart, more or less, just
hangs from the aortic arch
Much like a big pendulum.
If enough motion is placed on
the heart (i.e.. Deceleration
From a motor vehicle
accident, striking a tree while
skiing etc) the heart may tear
away from the aorta.
76. Traumatic Aortic RuptureTraumatic Aortic Rupture
The chances of survival are
very slim and are based on the
degree of the tear.
If there is just a small tear then
the patient may survive. If the
aorta is completely transected
then the patient will die
instantaneously
77. S/S Of Traumatic Aortic RuptureS/S Of Traumatic Aortic Rupture
Burning or Tearing Sensation inBurning or Tearing Sensation in
chest or shoulder bladeschest or shoulder blades
Rapidly dropping Blood PressureRapidly dropping Blood Pressure
Pulse Rapidly IncreasingPulse Rapidly Increasing
Decreased or loss of pulse or b/pDecreased or loss of pulse or b/p
on left side compared to right sideon left side compared to right side
Rapid Loss of ConsciousnessRapid Loss of Consciousness
78. Treatment of Traumatic AorticTreatment of Traumatic Aortic
RuptureRupture
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
High Flow oxygenHigh Flow oxygen
Treatment for ShockTreatment for Shock
RAPID TRANSPORTRAPID TRANSPORT
Contact Hospital and ALS Unit AsContact Hospital and ALS Unit As
soon as possiblesoon as possible
79. Traumatic AsphyxiaTraumatic Asphyxia
Results from suddenResults from sudden
compression injury to chestcompression injury to chest
cavitycavity
Can cause massive rupture ofCan cause massive rupture of
Vessels and organs of chestVessels and organs of chest
cavitycavity
Ultimately DeathUltimately Death
80. S/S of Traumatic AsphyxiaS/S of Traumatic Asphyxia
Severe DyspneaSevere Dyspnea
Distended Neck VeinsDistended Neck Veins
Bulging, Blood shot eyesBulging, Blood shot eyes
Swollen Tounge with cyanotic lipsSwollen Tounge with cyanotic lips
Reddish-purple discoloration ofReddish-purple discoloration of
face and neckface and neck
PetechiaePetechiae
81. Treatment for Traumatic AsphyxiaTreatment for Traumatic Asphyxia
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
High Flow oxygenHigh Flow oxygen
Treat for shockTreat for shock
Care for associated injuriesCare for associated injuries
82. Diaphragmatic RuptureDiaphragmatic Rupture
A tear in the Diaphragm thatA tear in the Diaphragm that
allows the abdominal organs enterallows the abdominal organs enter
the chest cavitythe chest cavity
More common on Left side due toMore common on Left side due to
liver helps protect the right side ofliver helps protect the right side of
diaphragmdiaphragm
Associated with multiple injuryAssociated with multiple injury
patientspatients
84. S/S of Diaphragmatic RuptureS/S of Diaphragmatic Rupture
Abdominal PainAbdominal Pain
Shortness of AirShortness of Air
Decreased Breath Sounds onDecreased Breath Sounds on
side of ruptureside of rupture
Bowel Sounds heard in chestBowel Sounds heard in chest
cavitycavity
85. Treatment of DiaphragmaticTreatment of Diaphragmatic
RuptureRupture
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
High Flow oxygenHigh Flow oxygen
Treat Associated InjuriesTreat Associated Injuries
Definitive treatment is surgeryDefinitive treatment is surgery
86. Various chest incisionsVarious chest incisions
Commonly used chest incisionsCommonly used chest incisions
1.Median sternotomy1.Median sternotomy
2.posterolateral thoracotomy2.posterolateral thoracotomy
3.Anterior thoracotomy3.Anterior thoracotomy
4.thoracoabdominal4.thoracoabdominal
87. Indications ofIndications of mmedianedian
sternotomysternotomy
Surgery forSurgery for
1.thymus1.thymus
2.heart and great vessels2.heart and great vessels
3.both pleural sac3.both pleural sac
89. Posterolateral thoracotomyPosterolateral thoracotomy
An incision is made in the bedAn incision is made in the bed
of the 5th rib (5th intercostalsof the 5th rib (5th intercostals
space).space).
Used mainly for hilum and lungUsed mainly for hilum and lung
surgery eg.pneumonectomysurgery eg.pneumonectomy