Thoracic trauma: Difference between revisions

Line 17: Line 17:
#[[Cardiac Tamponade]]
#[[Cardiac Tamponade]]
#[[Myocardial Contusion]]
#[[Myocardial Contusion]]
#[[Aortic Transection]]





Revision as of 03:14, 17 July 2011

Background

  • Must determine if injury also traverses the diaphragm (intra-abdominal injury)
    • Most deaths in thoracic trauma pts are due to noncardiothoracic injuries
  • Excessive PPV can lead to reduced venous return, tension ptx (avoid excess bagging)
  • Place central lines on the SAME side as existing injury or PTX (prevent b/l ptx)
  • Hypotensive resuscitation in chest trauma may be beneficial
  • w/ pnetrating chest inj neuro defecit should incr suspicion of vasc inj b/c nv bundle run together

DDx

  1. Traumatic Pneumothorax
  2. Tension Pneumothorax
  3. Hemothorax
  4. Flail Chest
  5. Sternum Fracture
  6. Traumatic Asphyxia
  7. Trachobronchial Injury
  8. Cardiac Tamponade
  9. Myocardial Contusion
  10. Aortic Transection


  • commotio cordis is most common cause of cardiac death in athlete. sudden death w/o abnl heart from trauma to cw at vent depolarization= vf & death.
  • esophageal inj is rare but bad & hard dx to make. rx=controversial if no sx. suspect if L htx or ptx w/o rib fx, or pneumomediastinum, d/t incr pressure of low chest/abd= tear in esoph!

See Also

Source

Tintinalli's