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Introduction to Epidemiology
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a flail chest occurs when
a segment of the chest wall is detached from the thoracic cage
immediate death from blunt chest trauma following a MVA is most often the result of
a traumatic aortic rupture
you arrive at the scene of a major MVA. the pt, a 50yr old female, was removed from her vehicle prior to your arrival. bystanders who removed her state that she was not wearing a seatbelt. the pt is unconscious, tachycardic, and diaphoretic. your assessment reveals bilaterally clear and equal breath sounds, a midline
trachea, and collapsed jugular veins. you should be most suspicious that this pt has experience a:
which of the following organs or structures does NOT reside within the mediastinum?
a spontaneous pneumothorax would most likely occur as a result of:
exertion of a person with a
congenital lung defect
a 19 yr old male is unresponsive, apneic, and pulseless after being struck in the center of the chest with a softball. Based on the MOI, what most likely occured?
ventricular fibrillation when the impact occurred during a critical portion of the cardiac cycle
a 28 yr old male was struck in the chest with a baseball bat during an altercation. he is conscious and alert and complains of severe chest pain. your assessment reveals a large area of ecchymosis over the sternum and a rapid, irregular pulse. in addition to applying 100% oxygen, you should:
prepare for immediate transport
following blunt trauma to the chest, an 18 yr old female presents with respiratory distress, reduced tidal volume, and cyanosis. her bp is 80/50 and her pulse is 130 beats/min and thready. you should:
provide some form of positive pressure ventilation
common s/s of a chest injury include all of the following,
EXCEPT:
you respond to a residence for a 40 yr old female who was assualted by her husband; the scene has been secured by law enforcement. upon your arrival, you find the pt lying supine on the floor in the kitchen. she is semiconscious with severley labored breathing. further assessment reveals a large bruise to the left anterior chest, JVD, and unilaterally absent breath sounds.
as your partner is supporting ventilations, you should:
immediately request ALS support
if a pt with a chest injury is only able to inhale small amounts of air per breath, he or she:
must increase his or her respiratory rate to maintain adequate minute volume
elevation of the rib cage during inhilation occurs when
the intercostal muscle contract
a rapid, irregular pulse following blunt trauma to the chest is most suggestive of a
pleural fluid is
contained between the
visceral and parietal pleurae
when a person is lying supine at the end of exhalation, the diaphragm
may rise a high as the nipple line
subcutaneous
emphysema is an indication that
air is escaping into the chest wall from a damaged lung
you are transporting a stable pt with a possible pneumothorax. the pt is receiving 100% oxygen and has an oxygen sat of 95%. during your re-assessment, you find that the pt is now confused, hypotensive and profusely diaphoretic.
what is most likely causing this pt's deterioration
compression of the aorta and vena cava
irritation or damage to the pleural surfaces that causes sharp chest pain during inhalation is called:
you have sealed the open chest wound of a 40 yr old male who was stabbed in the
anterior chest. your assessment reveals that he is experiencing increasing respiratory distress and tachycardia, and is developing cyanosis. you should
partially remove the dressing
while jogging, a 19 yr old male experience an acute onset of shortness of breath and pleuritic chest pain. he is conscious and alert with stable
vital signs. your assessment reveals that he has diminished breath sounds over the left side of the chest. you should
administer oxygen and transport to the hospital
the ________ nerves control the diaphragm
a 37 yr old male was pinned between a flatbed truck and a
loading dock. on exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. you should:
aggressively manage his airway
the phrenic nerves control the diaphragm and exit the spinal cord at the
pneumothorax
is defined as
accumulation of air in the pleural space