Thoracic trauma: Difference between revisions
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*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! | *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! |
Revision as of 03:19, 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
- Traumatic Pneumothorax
- Tension Pneumothorax
- Hemothorax
- Flail Chest
- Sternum Fracture
- Traumatic Asphyxia
- Trachobronchial Injury
- Cardiac Tamponade
- Myocardial Contusion
- Aortic Transection
- 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