Pulmonary contusion: Difference between revisions

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==Background==
==Background==
 
*Direct damage to lung causing alveolar hemorrhage, edema, and debris accumulation
 
*direct damage to lung causing alveolar hemor & edema & mucus/debris accumulation
 
   
   
==Diagnosis==
==Diagnosis==
*Signs/symptoms
**SOB
**Tachypnea
**Cyanosis
**Hypotension
**Rales
**Hypoxia
**Wide a-A


 
==Imaging==
*pts= sob, tachy, cyanosis, low bp, rales, hypoxia, wide a-A
*CXR
 
**Patchy irregular infiltrates
*cxr= patchy irregular infiltrates, always see by 4-6 hr, always worse than 1st xr shows!
**Always seen by 4-6 hr, always worse than what the 1st CXR shows
 
***Do not treat the CXR, treat the patient
*CXR does NOT give clues to physiologic effects of contusion (ie, Rx pt & sx NOT CXR, even small contusion can be bad, watch pt sats & abg!!)
**Flail chest almost always associated with contusion
 
*flail chest= 2 or more rib fx @ 2 or more points, problem w/ this is the underlying contusion almost 100% hve!
 


==Treatment==
==Treatment==
 
*If need to intubate: low tidal volume, high PEEP
 
*Rx= peep b/c response to O2 is poor, intubate prn & low TV & high PEEP vent setting has become standard practice!
 
*if possible intubate each side b/c peep can blow out lung + may need diff settings for ea lung.
 
*steroids improve cxr but NOT outcome, abx iff aspiration o/w no chng in outcome


   
   
==See Also==
==See Also==




(Burbulys 2004/Trauma Reports 4/04 /A-Digest 7/04) -by Lampe
==Source==
 
*Trauma Reports 4/04
 
 




[[Category:Trauma]]
[[Category:Trauma]]

Revision as of 07:36, 5 April 2011

Background

  • Direct damage to lung causing alveolar hemorrhage, edema, and debris accumulation

Diagnosis

  • Signs/symptoms
    • SOB
    • Tachypnea
    • Cyanosis
    • Hypotension
    • Rales
    • Hypoxia
    • Wide a-A

Imaging

  • CXR
    • Patchy irregular infiltrates
    • Always seen by 4-6 hr, always worse than what the 1st CXR shows
      • Do not treat the CXR, treat the patient
    • Flail chest almost always associated with contusion

Treatment

  • If need to intubate: low tidal volume, high PEEP


See Also

Source

  • Trauma Reports 4/04