This document provides an overview of chest trauma. It begins by defining chest trauma as any injury to the chest, including the ribs, heart and lungs. Chest injuries are categorized as open or closed. Common causes are discussed, including blunt trauma from accidents or penetrating trauma from objects. Signs and symptoms, diagnostic tests, and specific injuries like pneumothorax are described. Treatment focuses on ABCs - airway, breathing and circulation while performing tests to evaluate cardiac and pulmonary function.
2. SEMINAR ONSEMINAR ON
CHEST TRAUMACHEST TRAUMA
MR OM VERMAMR OM VERMA
Msc lecturer medical surgical nursingMsc lecturer medical surgical nursing
3. INTRODUCTION:INTRODUCTION:
The chest is a large exposure part of theThe chest is a large exposure part of the
body that is very vul-nerable to impactbody that is very vul-nerable to impact
injuries. Because it houses the heart, lungs,injuries. Because it houses the heart, lungs,
and great vessels, chest trauma frequentlyand great vessels, chest trauma frequently
produces life threate-ning disruption. Injuryproduces life threate-ning disruption. Injury
to the thoracic case and its contraction canto the thoracic case and its contraction can
restrict the hearts ability to functionrestrict the hearts ability to function
properly.properly.
4. Chest Injuries are broken into 2Chest Injuries are broken into 2
categories:categories:
– 1. Open chest injury-Must have opening or1. Open chest injury-Must have opening or
break in skin.break in skin.
– 2. Closed chest injury-Usually from blunt2. Closed chest injury-Usually from blunt
trauma to chest cavity.trauma to chest cavity.
5. DEFINITION:DEFINITION:
Chest Trauma / Thoracic TraumaChest Trauma / Thoracic Trauma
is a serious injury of the chest.is a serious injury of the chest.
Any trauma which leads to injuryAny trauma which leads to injury
to chest is termed as chestto chest is termed as chest
trauma.trauma.
6. A CHEST INJURY IS ANY FROM OFA CHEST INJURY IS ANY FROM OF
PHYSICAL INJURY TO THE CHESTPHYSICAL INJURY TO THE CHEST
INCLUDING THE RIBS ,HEART,INCLUDING THE RIBS ,HEART,
LUNGSLUNGS
8. Main Causes of ChestMain Causes of Chest
TraumaTrauma
Blunt TraumaBlunt Trauma- Blunt force to chest.- Blunt force to chest.
( gun shorts )( gun shorts )
Penetrating TraumaPenetrating Trauma- Projectile that- Projectile that
enters chest causing small or large hole.enters chest causing small or large hole.
Compression InjuryCompression Injury- Chest is caught- Chest is caught
between two objects and chest isbetween two objects and chest is
compressed.compressed.
9. Thoracic TraumaThoracic Trauma
Blunt TraumaBlunt Trauma
– Results from kinetic energy forcesResults from kinetic energy forces
Subdivision MechanismsSubdivision Mechanisms
– BlastBlast
Pressure wave causes tissue disruptionPressure wave causes tissue disruption
Tear blood vessels & disrupt alveolar tissueTear blood vessels & disrupt alveolar tissue
Disruption of tracheobronchial treeDisruption of tracheobronchial tree
Traumatic diaphragm ruptureTraumatic diaphragm rupture
– Crush (Compression)Crush (Compression)
Body is compressed between an object and a hard surfaceBody is compressed between an object and a hard surface
Direct injury of chest wall and internal structuresDirect injury of chest wall and internal structures
– DecelerationDeceleration
Body in motion strikes a fixed objectBody in motion strikes a fixed object
Blunt trauma to chest wallBlunt trauma to chest wall
Internal structures continue in motionInternal structures continue in motion
– Ligamentum ArteriosumLigamentum Arteriosum shears aortashears aorta
– Age FactorsAge Factors
Pediatric Thorax: More cartilage = Absorbs forcesPediatric Thorax: More cartilage = Absorbs forces
Geriatric Thorax: Calcification & osteoporosis = More fracturesGeriatric Thorax: Calcification & osteoporosis = More fractures
11. A. AirwayA. Airway
Assess for airway patency and airAssess for airway patency and air
exchange - listen at nose & mouthexchange - listen at nose & mouth
Assess for intercostal andAssess for intercostal and
supraclavicular muscle retractionssupraclavicular muscle retractions
Assess oropharynx for foreign bodyAssess oropharynx for foreign body
obstructionobstruction
12. B. BreathingB. Breathing
Assess respiratory movements andAssess respiratory movements and
quality of respirations - look, listen, feel.quality of respirations - look, listen, feel.
Slow respirations are early indicator ofSlow respirations are early indicator of
distress - cyanosis isdistress - cyanosis is late.late.
13. C.C. CirculationCirculation
Skin - look and feel for color,Skin - look and feel for color,
temperature, capillary refill- Look fortemperature, capillary refill- Look for
cyanosis.cyanosis.
Assess pulses for quality, rate, regularityAssess pulses for quality, rate, regularity
Look at neck veins - flat vs. distended-Look at neck veins - flat vs. distended-
fluid deficit or decreased supply to bodyfluid deficit or decreased supply to body
from heart due to compression.from heart due to compression.
Assess the B.P.Assess the B.P.
15. COMPRESSION OF LARGE VEINSCOMPRESSION OF LARGE VEINS
CARBON OXIDE DECREASESCARBON OXIDE DECREASES
CARDIAC ARRYTHMIASCARDIAC ARRYTHMIAS
a condition in which the heart beats with ana condition in which the heart beats with an
irregular or abnormal rhythm.irregular or abnormal rhythm.
SUDDEN DEATHSUDDEN DEATH
17. CHEST X- RAYCHEST X- RAY
Chest XChest X--raysrays produce images of your produce images of your
heart, lungs, blood vessels, airways, andheart, lungs, blood vessels, airways, and
the bones of your the bones of your chestchest and spine and spine
CT SCANCT SCAN
A A chest injurychest injury is any form of physical is any form of physical
injury to the chest including the ribs, heartinjury to the chest including the ribs, heart
and lungs. ... Diagnosis of blunt injuriesand lungs. ... Diagnosis of blunt injuries
may be more difficult and requiremay be more difficult and require
additional investigations such as additional investigations such as CTCT
scanningscanning..
18. ECHOCARDIOGRAPHYECHOCARDIOGRAPHY
EchocardiographyEchocardiography is a diagnostic test is a diagnostic test
that uses ultrasound waves to create anthat uses ultrasound waves to create an
image of the heart muscle, lungs .image of the heart muscle, lungs .
Ultrasound the heart can show the size,Ultrasound the heart can show the size,
shape, and movement of the heart'sshape, and movement of the heart's
valves and chambers as well as the flowvalves and chambers as well as the flow
of blood through the heart.of blood through the heart.
19. ABG ANALYSISABG ANALYSIS
An An arterial blood gasarterial blood gas ( (ABGABG) test) test
measures the acidity (pH) and themeasures the acidity (pH) and the
levels of oxygen and carbon dioxide inlevels of oxygen and carbon dioxide in
the blood from an artery. This test isthe blood from an artery. This test is
used to check how well your lungs areused to check how well your lungs are
able to move oxygen into the bloodable to move oxygen into the blood
and remove carbon dioxide from theand remove carbon dioxide from the
blood.blood.
20. ANGIOGRAPHYANGIOGRAPHY
CT angiographyCT angiography uses a uses a CTCT scanner scanner
to produce detailed images of bothto produce detailed images of both
blood vessels and tissues in variousblood vessels and tissues in various
parts of the body. An iodine-richparts of the body. An iodine-rich
contrast material (dye) is usuallycontrast material (dye) is usually
injected through a small catheterinjected through a small catheter
placed in a vein of the arm.placed in a vein of the arm.
22. 1. Simple/Closed1. Simple/Closed
PneumothoraxPneumothorax
o Accumulation of air in the pleural space without anAccumulation of air in the pleural space without an
apparent antecedent event.apparent antecedent event.
o Caused by rupture of smallCaused by rupture of small
blebs(small sac of the air ) on the visceral pleuralblebs(small sac of the air ) on the visceral pleural
spacespace
o Blunt trauma is mainBlunt trauma is main
o May be spontaneousMay be spontaneous
o Usually self correctingUsually self correcting
23. S/S of Simple/ClosedS/S of Simple/Closed
PneumothoraxPneumothorax
Pleuritic Chest PainPleuritic Chest Pain
DyspnoeaDyspnoea
Tachypnea ( ABNORMAL RAPIDTachypnea ( ABNORMAL RAPID
BRATHING )BRATHING )
Decreased Breath Sounds onDecreased Breath Sounds on
Affected SideAffected Side
Hypertymphany to percussionHypertymphany to percussion
( like sound heard over air filled( like sound heard over air filled
structure during the abdominalstructure during the abdominal
examination
24. Treatment for Simple/ClosedTreatment for Simple/Closed
PneumothoraxPneumothorax
ABC’s with C-spine controlABC’s with C-spine control
Administer high concentration of oxygen to treatAdminister high concentration of oxygen to treat
hypoxiahypoxia
Remove clothing to assess injuryRemove clothing to assess injury
Insert chest tube with connection to suction toInsert chest tube with connection to suction to
remove remaining air and fluid / water sealremove remaining air and fluid / water seal
drainagedrainage
Constant monitoringConstant monitoring
Opening is plugged to align it with gauzeOpening is plugged to align it with gauze
impregnated with petroleum. A pressure dressingimpregnated with petroleum. A pressure dressing
is applied and secured with a circumferential strapis applied and secured with a circumferential strap
Give semi- fowlers position or on injured siteGive semi- fowlers position or on injured site
Administer AntibioticsAdminister Antibiotics
25. Ongoing monitoringOngoing monitoring
Vital signsVital signs
Level of consciousnessLevel of consciousness
Oxygen saturationOxygen saturation
Cardiac rhythmCardiac rhythm
Respiratory statusRespiratory status
Urinary outputUrinary output
26. 2. Open Pneumothorax2. Open Pneumothorax
Opening in chest cavityOpening in chest cavity
that allows air tothat allows air to
enter pleural cavity.enter pleural cavity.
Causes the lung toCauses the lung to
collapse due to increasedcollapse due to increased
pressure in pleural cavity.pressure in pleural cavity.
E.g. Stab/ gunshot wounds.E.g. Stab/ gunshot wounds.
Can be life threatening andCan be life threatening and
can deteriorate rapidlycan deteriorate rapidly
34. S/S of OpenS/S of Open
PneumothoraxPneumothorax
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
wound ( a.k.a. Sucking chestwound ( a.k.a. Sucking chest
wound)wound)
35. SubcutaneousSubcutaneous
EmphysemaEmphysema
Air collects in subcutaneous fat fromAir collects in subcutaneous fat from
pressure of air in pleural cavitypressure of air in pleural cavity
Feels like rice crispies or bubble wrapFeels like rice crispies or bubble wrap
Can be seen from neck to groin areaCan be seen from neck to groin area
37. Treatment for OpenTreatment for Open
PneumothoraxPneumothorax
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
High Flow oxygenHigh Flow oxygen
Listen for decreased breath sounds onListen for decreased breath sounds on
affected sideaffected side
Apply occlusive dressing to woundApply occlusive dressing to wound
Notify HospitalNotify Hospital
38. Occlusive/ Vented DressingOcclusive/ Vented Dressing
Allows air to escapeAllows air to escape
from the vent andfrom the vent and
decreases thedecreases the
likelihood of tensionlikelihood of tension
pneumothoraxpneumothorax
developingdeveloping
40. 3. Tension3. Tension
PneumothoraxPneumothorax
Air builds in pleural space with noAir builds in pleural space with no
where for the air to escapewhere for the air to escape
Results in collapse of lung on affectedResults in collapse of lung on affected
side that results in pressure onside that results in pressure on
mediastium,the other lung, and greatmediastium,the other lung, and great
vesselsvessels
44. S/S of TensionS/S of Tension
PneumothoraxPneumothorax
Anxiety/RestlessneAnxiety/Restlessne
ssss
Severe DyspneaSevere Dyspnea
Absent BreathAbsent Breath
sounds on affectedsounds on affected
sideside
TachypneaTachypnea
TachycardiaTachycardia
Poor ColorPoor Color
Accessory MuscleAccessory Muscle
UseUse
JVDJVD
Narrowing PulseNarrowing Pulse
PressuresPressures
HypotensionHypotension
Tracheal DeviationTracheal Deviation
(late if seen at all)(late if seen at all)
45. TREATMENTTREATMENT
Monitor Cardiac RhythmMonitor Cardiac Rhythm
Establish IV access and Draw BloodEstablish IV access and Draw Blood
SamplesSamples
Airway control including IntubationAirway control including Intubation
Needle Decompression of AffectedNeedle Decompression of Affected
SideSide
46. Needle DecompressionNeedle Decompression
Locate 2-3 Intercostals space midclavicularLocate 2-3 Intercostals space midclavicular
lineline
Cleanse area using aseptic techniqueCleanse area using aseptic technique
Insert catheter ( 14g or larger) at least 3” inInsert catheter ( 14g or larger) at least 3” in
length over the top of the 3length over the top of the 3rdrd
rib( nerve,rib( nerve,
artery, vein lie along bottom of rib)artery, vein lie along bottom of rib)
Remove Stylette ( a flexible metallic rodRemove Stylette ( a flexible metallic rod
inserted in the lumen of a flexible catheter )inserted in the lumen of a flexible catheter )
and listen for rush of airand listen for rush of air
Place Flutter valve over catheterPlace Flutter valve over catheter
Reassess for ImprovementReassess for Improvement
48. 4, Hemothorax4, Hemothorax
Occurs when pleural space fills withOccurs when pleural space fills with
bloodblood
Usually occurs due to lacerated bloodUsually occurs due to lacerated blood
vessel in thoraxvessel 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 of bloodEach Lung can hold 1.5 liters of blood
56. S/S of HemothoraxS/S of Hemothorax
Anxiety/RestlessnessAnxiety/Restlessness
TachypneaTachypnea
Signs of ShockSigns of Shock
Frothy, Bloody SputumFrothy, Bloody Sputum
Diminished Breath Sounds on AffectedDiminished Breath Sounds on Affected
SideSide
TachycardiaTachycardia
Flat Neck VeinsFlat Neck Veins
57. Treatment forTreatment for
HemothoraxHemothorax
ABC’s with c-spine control asABC’s with c-spine control as
indicatedindicated
Secure Airway assist ventilation ifSecure Airway assist ventilation if
necessarynecessary
General Shock Care due to Blood lossGeneral Shock Care due to Blood loss
Consider Left Lateral RecumbentConsider Left Lateral Recumbent
position if not contraindicatedposition if not contraindicated
RAPID TRANSPORTRAPID TRANSPORT
Contact HospitalContact Hospital
58. 5. Flail Chest5. Flail Chest
The breaking of 2The breaking of 2
or more ribs in 2or more ribs in 2
or more placesor more places
60. S/S of Flail ChestS/S of Flail Chest
Shortness of Breath, respiratoryShortness of Breath, respiratory
distress, Pneumothoraxdistress, Pneumothorax
Paradoxical MovementParadoxical Movement
Bruising/SwellingBruising/Swelling
Crepitus( Grinding of bone ends onCrepitus( Grinding of bone ends on
palpation)palpation)
HypotensionHypotension
61. Treatment of Flail ChestTreatment of Flail Chest
Flail Chest is a True EmergencyFlail Chest is a True Emergency
Ensure airwayEnsure airway
Administer oxygenAdminister oxygen
Assist ventilation. Chest decompression is doneAssist ventilation. Chest decompression is done
for pneumothorax.for pneumothorax.
Establish I/V lineEstablish I/V line
Restrict fluid intake, prescribe corticosteroids andRestrict fluid intake, prescribe corticosteroids and
albumin to treat pulmonary contusionalbumin to treat pulmonary contusion
Prepare for operative stabilization of chest wallPrepare for operative stabilization of chest wall
62. Bulky Dressing for splintBulky Dressing for splint
of Flail Chestof Flail Chest
Use TraumaUse Trauma
bandage andbandage and
TriangularTriangular
Bandages to splintBandages to splint
ribs.ribs.
Can also place aCan also place a
bag of D5W onbag of D5W on
area and tapearea and tape
down. (The onlydown. (The only
good use of D5W Igood use of D5W I
can find)can find)
63. 6. Pericardial6. Pericardial
TamponadeTamponade Blood and fluidsBlood and fluids
leak into theleak into the
pericardial sacpericardial sac
which surrounds thewhich surrounds the
heart.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 anymoreexpand anymorepericardial sac
64. Pericardial TamponadePericardial Tamponade
Once theOnce the
pericardial sacpericardial sac
can’t expandcan’t expand
anymore, theanymore, the
fluid starts puttingfluid starts putting
pressure on thepressure on the
heartheart
Now the heartNow the heart
can’t fully expandcan’t fully expand
and can’t pumpand can’t pump
effectively.effectively.
65. Pericardial TamponadePericardial Tamponade
With poor pumpingWith poor pumping
the blood pressurethe blood pressure
starts to drop.starts to drop.
The heart rate startsThe heart rate starts
to increase toto increase to
compensate but iscompensate but is
unableunable
The patient’s level ofThe patient’s level of
conscious drops, andconscious drops, and
eventually the patienteventually the patient
goes in cardiac arrestgoes in cardiac arrest
66. pericardial tamponadepericardial tamponade ,,
is when fluid inis when fluid in
the the pericardiumpericardium (the sac (the sac
around the heart) builds up andaround the heart) builds up and
results in compression of theresults in compression of the
heart. .heart. .
68. Treatment of PericardialTreatment of Pericardial
TamponadeTamponade
Check for ABCCheck for ABC
High Flow oxygen which may includeHigh Flow oxygen which may include
BVMBVM
Treat S/S of shockTreat S/S of shock
Assist with pericardiocentesisAssist with pericardiocentesis
Prepare for emergency thoracotomyPrepare for emergency thoracotomy
70. PericardiocentesisPericardiocentesis
Using aseptic technique, Insert at least needle atUsing aseptic technique, Insert at least needle at
the angle of the Xiphoid Cartilage at the 7the angle of the Xiphoid Cartilage at the 7thth
ribrib
Advance needle at 45 degree towards the clavicleAdvance needle at 45 degree towards the clavicle
while aspirating syringe till blood return is seenwhile aspirating syringe till blood return is seen
Continue to Aspirate till syringe is full then discardContinue to Aspirate till syringe is full then discard
blood and attempt again till signs of no more bloodblood and attempt again till signs of no more blood
Closely monitor patient due to small about of bloodClosely monitor patient due to small about of blood
aspirated can cause a rapid change in bloodaspirated can cause a rapid change in blood
pressurepressure
71. 7. Traumatic Aortic7. Traumatic Aortic
RuptureRupture
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.
72. 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
73. S/S Of Traumatic AorticS/S Of Traumatic Aortic
RuptureRupture
Burning or Tearing Sensation in chestBurning or Tearing Sensation in chest
or shoulder bladesor shoulder blades
Rapidly dropping Blood PressureRapidly dropping Blood Pressure
Pulse Rapidly IncreasingPulse Rapidly Increasing
Decreased or loss of pulse or b/p onDecreased or loss of pulse or b/p on
left side compared to right sideleft side compared to right side
Rapid Loss of ConsciousnessRapid Loss of Consciousness
74. TreatmentTreatment
Monitor Cardiac RhythmMonitor Cardiac Rhythm
Large Bore IV therapy probably 2 andLarge Bore IV therapy probably 2 and
draw blood samplesdraw blood samples
Airway management that may includeAirway management that may include
IntubationIntubation
75. 8. Traumatic Asphyxia8. Traumatic Asphyxia
Results from sudden compressionResults from sudden compression
injury to chest cavityinjury to chest cavity
Can cause massive rupture of VesselsCan cause massive rupture of Vessels
and organs of chest cavityand organs of chest cavity
Ultimately DeathUltimately Death
76. S/S of TraumaticS/S of Traumatic
AsphyxiaAsphyxia
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 of faceReddish-purple discoloration of face
and neckand neck
PetechiaePetechiae
77. TreatmentTreatment
Cardiac MonitorCardiac Monitor
Establish IV Access and draw bloodEstablish IV Access and draw blood
samplessamples
Airway control including IntubationAirway control including Intubation
Rapid transportRapid transport
78. 9. Diaphragmatic9. Diaphragmatic
RuptureRupture
A tear in the Diaphragm that allowsA tear in the Diaphragm that allows
the abdominal organs enter the chestthe abdominal organs enter the chest
cavitycavity
More common on Left side due to liverMore common on Left side due to liver
helps protect the right side ofhelps protect the right side of
diaphragmdiaphragm
Associated with multipile injuryAssociated with multipile injury
patientspatients
80. S/S of DiaphragmaticS/S of Diaphragmatic
RuptureRupture
Abdominal PainAbdominal Pain
Shortness of AirShortness of Air
Decreased Breath Sounds on side ofDecreased Breath Sounds on side of
rupturerupture
Bowel Sounds heard in chest cavityBowel Sounds heard in chest cavity
81. TreatmentTreatment
Cardiac MonitorCardiac Monitor
Establish IV access and draw bloodEstablish IV access and draw blood
samplessamples
Airway management including IntubationAirway management including Intubation
Observe for Pneumothorax due toObserve for Pneumothorax due to
compression on lung by abdominal contentscompression on lung by abdominal contents
Possible insertion of NG tube to helpPossible insertion of NG tube to help
decompress the stomach to relieve pressuredecompress the stomach to relieve pressure
82. Management of patients withManagement of patients with
Thoracic TraumaThoracic Trauma
The treatment of polytraumatized patient mustThe treatment of polytraumatized patient must
follow a certain protocol which includes.follow a certain protocol which includes.
– Adequate oxygenation.Adequate oxygenation.
– Fluid replacement.Fluid replacement.
– Surgical intervention.Surgical intervention.
– Treatment of septic complications.Treatment of septic complications.
– Adequate caloric and substrate supplementation.Adequate caloric and substrate supplementation.
– Prevention of stress bleeding.Prevention of stress bleeding.
– Finally, be alert of possible complication (CNS, ARDS,Finally, be alert of possible complication (CNS, ARDS,
hepatic, renal, coagulation disorders, sepsis.hepatic, renal, coagulation disorders, sepsis.
83. RIB FRACTURE:RIB FRACTURE:
SIGN AND SYMPTOMS:
SEVERE PAIN, TENDERNESSSEVERE PAIN, TENDERNESS
MUSCLE SPASM WHICH AGGRAVATEMUSCLE SPASM WHICH AGGRAVATE
WITH COUGHING , DEEP BREATHINGWITH COUGHING , DEEP BREATHING
AND MOTIONAND MOTION
CRACKLING SOUND WITH GRATINGCRACKLING SOUND WITH GRATING
UNSTABLE RIB CAGE ON PALPATIONUNSTABLE RIB CAGE ON PALPATION
84. TREATMENTTREATMENT
ENSURE AIRWAY AND ADMINISTERENSURE AIRWAY AND ADMINISTER
OXYGENOXYGEN
Stabilize with hand followed by applicationStabilize with hand followed by application
of large pieces of tape horizontal acrossof large pieces of tape horizontal across
the flail segmentthe flail segment
GIVE ANALGESICGIVE ANALGESIC
ENCOURAGE FOR DEEP BREATHINGENCOURAGE FOR DEEP BREATHING
MAINTAIN PATENT I/V LINEMAINTAIN PATENT I/V LINE
85. ASSESSMENT:ASSESSMENT:
A-A- AIRWAY MAINTENANCE WITHAIRWAY MAINTENANCE WITH
CERVICAL SPINE PROTECTIONCERVICAL SPINE PROTECTION
B-B- BREATHING AND VENTILATIONBREATHING AND VENTILATION
C-C- CIRCULATION WITH HEMORRHAGECIRCULATION WITH HEMORRHAGE
CONTROLCONTROL
D-D- DISABILITY, NEUROLOGICALDISABILITY, NEUROLOGICAL
STATUSSTATUS
E-E- EXPOSURE/ ENVIRONMENTALEXPOSURE/ ENVIRONMENTAL
CONTROL, PREVENT HYPOTHERMIACONTROL, PREVENT HYPOTHERMIA
86. NURSING PROCESSNURSING PROCESS
INEFFECTIVE BREATHING PATTERN RELATEDINEFFECTIVE BREATHING PATTERN RELATED
TO CHEST INJURYTO CHEST INJURY
RISK FOR DEFICIENT FLUID VOLUME RELATEDRISK FOR DEFICIENT FLUID VOLUME RELATED
TO CHEST DRAINAGE AND BLOOD LOSSTO CHEST DRAINAGE AND BLOOD LOSS
ACUTE PAIN RELATED TO CHEST INJURY ANDACUTE PAIN RELATED TO CHEST INJURY AND
PRESENCE OF DRAINAGE TUBES IN THE CHESTPRESENCE OF DRAINAGE TUBES IN THE CHEST
IMPAIRED PHYSICAL MOBILITY RELATED TOIMPAIRED PHYSICAL MOBILITY RELATED TO
PAIN, MUSCLE INJURYPAIN, MUSCLE INJURY
RISK FOR INEFFECTIVE INDIVIDUAL COPINGRISK FOR INEFFECTIVE INDIVIDUAL COPING
RELATED TORELATED TO
TEMPORARY DEPENDENCE AND LOSS OF FULLTEMPORARY DEPENDENCE AND LOSS OF FULL
RESPIRATORY FUNCTIONRESPIRATORY FUNCTION
87. COMPLICATIONCOMPLICATION
ASPIRATIONASPIRATION
ATELECTESIS ( collapse or closure ofATELECTESIS ( collapse or closure of
a lung )a lung )
INFECTIONINFECTION
PNEUMONIAPNEUMONIA
RESPIRARATORY FAILURERESPIRARATORY FAILURE
=inadequate gas exchange by the=inadequate gas exchange by the
respiratory systemrespiratory system
88. SummarySummary
Chest Injuries are common and often lifeChest Injuries are common and often life
threatening in trauma patients. So, Rapidthreatening in trauma patients. So, Rapid
identification and treatment of these patients isidentification and treatment of these patients is
paramount to patient survival. Airwayparamount to patient survival. Airway
management is very important and aggressivemanagement is very important and aggressive
management is sometimes needed for propermanagement is sometimes needed for proper
management of most chest injuries.management of most chest injuries.