ATCN review Questions and Answers(A+ Solution guide)

10 Signs and sx of tension pneumothorax - pain hunger ratory distress cardia ension eal deviation away from injury teral absence of breath sounds ted hemithorax w/out respiratory movement vein distention sis (late sign) Signs and sx of cardiac tamponade - 1. Becks Triad= increased venous pressure(distended neck veins), decreased arterial pressure(hypotension), muffled heart tones 2. PEA 3. JVD &/or Kussmauls sign 4. Use FAST to dx tension pneumothorax can often be confused with cardiac tamponade, how do you differentiate? - Careful assessment of the pt's breath sounds is paramount to differentiate the two Tx of tension pneumothorax - 1. Needle decompression- large bore needle 2nd intercostal space midclavicular line 2. chest tube 4 or 5th intercostal space mid axillary triad of death - -Acidosis - Hypothermia - Coagulopathy (blood can't clot resulting in continued bleeding)rule of 9's adult - Head = 9% Chest (front) = 9% Abdomen (front) = 9% Upper/mid/low back and buttocks = 18% Each arm = 9% (front = 4.5%, back = 4.5%) Groin = 1% Each leg = 18% total (front = 9%, back = 9%) Rule of 9's - Pediatric - Anterior/Posterior Head - 9% Each Anterior/Posterior Torson - 18% Each Anterior/Posterior Arms - 4.5% Each Anterior/Posterior Legs - 7% Each signs and symptoms of compartment syndrome - Early signs and sx 1. increased pain, greater than expected and out of proportion to the injury 2. Palpable tenseness of the compartment 3. asymmetry of the muscle compartment 4. pain on passive stretch ed sensation Note: Absent distal pulses and poor cap refill are not reliable in dx compartment syndrome. May be a very late sign of C.S. possibility of proximal vascular injury should be considered Indications for thoracotomy - thoracotomy is indicated when output exceeds 1500 mL within 24 hours, THE INDICATIONS for thoracotomy after traumatic injury typically include shock, arrest at presentation, diagnosis of specific injuries (such as blunt aortic injury), or ongoing thoracic hemorrhage. blunt cardiac injury s and sx - sx can be slow and gradual and silent. hypotension, tachycardia, arrhythmias and dysrhythmias, visible trauma, distended neck veins, muffled heart sounds, and other signs of shock.