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where on the tissue oxygenation cascade is thoracic cage
fractures a problem
ventilation
parameters to assess ventilation
ETCO2, PaCO2, clinical assessment
what are considered "great vessels"
thorax
what type of injuries occur when the lungs are subjected to
force?
bruise =
contusion
tear =
lacerations
,pop =
punctures
inhalation injury
bruise on the lungs
pulmonary contusion
causes of pulmonary contusions
high speed blunt or penetrating injury
what happens to the lungs in pulmonary contusions
big boggy bruise on
the lungs diffusion
problems
when it becomes contused & edematous, it becomes difficult
for oxygen to move from the alveoli into the capillaries
where on the tissue oxygenation cascade do pulmonary
contusions cause their problems
diffusion
all contusions over time
all contusions "blossom" over time. the full extent of the injury
is not initially apparent
,important thing to remember when you are evaluating a
patient for pulmonary contusions
70% of pulmonary contusions aren't initial on the initial CXR
what should you monitor when a pt has trauma to the throax
closely monitor for pulmonary contustiobs = 70% not
present on the initial CXR and "blossom" over time
-monitor for progress e deterioration in hours/days post injury
*might look ok in ER
best parameter of serial monitoring for pt's who have risk
factors for pulmonary contusions
anticipate "blossoming" over time b/c 70% of pulmonary
contusions aren't present on the initial CXR
P:F ratio
problem of using CXR as a definitive clinical dx tool
CXR may lag behind clinical status
*b/c 70% of pulmonary contusions aren't present on initial
CXR. they "blossom" over time
tear in lung tissue
pulmonary laceration
problem of pulmonary lacerations
risk of massive hemothoax b/c those vessels are very vascular
, simple v. tension v. open v. closed. v. hemothorax v.
hemopneumothorax
what is a simple pneumothorax
any air that enters the pleural cavity can also leave at the
same rate. lungs deflated but no increase in intrathroacic
pressure. air in/out exits at the same rate. pt might be able to
tolerate a simple pneumothraox
causes a problem at the ventilation point at the tissue oxygen
cascade
intrathroacic pressure in simple pneumothorax
air that enters the pleural cavity
leaves at the same rate lungs are
deflated but no increase in
pressure
air in/out at the same rate
where is the problem in the tissue oxygenation cascade in
simple pneumothroax
ventilation
what happens in penumothorax
lungs are collapsed/deflated
aire enters space between the visceral & parietal