1.Chest x-ray: pneumonia, effusion, cardiomegaly, pneumothorax
2.EKG: MI, dysrhythmias
3.Labs: troponin, CMP, CBC: infection, lytes, creat, anemia, MI
4.Weakness might get UA and/or septic workup if older adult - why?
§What would they need if I added in tachycardia and a fever?
§All the above and:
§Knowing the pattern of injury and the history of the injury event can help us predict and be prepared for the manifestations of certain injuries
§Combination of patient's age, mechanism of injury, anatomic structures involves, and pre-existing factors (alcohol ingestion, restraint system, comorbid conditions)
§MVC: use or non-use of restraints, position of victim in vehicle, type of collision (rear impact, head-on, etc.), speed
§Fall: distance of fall, surface landed on, anatomic point of impact
§Assault: points of impact, weapons used
§Tension pneumothorax: LIFE THREATENING. Why?
§________can lead to tampanode __________
§Classic sx:____paradoxical breathing, hypotension, JVD, tracheal deviation, muffled heart sounds___________
§Open pneumothorax (AKA sucking chest wound)
§Can be a significant source of blood loss leading to shock.
§2.5 L of blood can be lost into each lung (can lead to hypovolemic shock
§Treatments:____chest tube or needle aspiration________
These would be life-threatening injuries that should be treated in primary survey
A tension pneumothorax is a life-threatening condition that develops when air is trapped in the pleural cavity under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function -->potential cardiac tamponade.
Classic sx tension pneumo: hypotension, tracheal deviation, and neck vein distention. Dim to absent LS, hyperresonant (lower pitch) to percussion and often feels somewhat distended, tense, and poorly compressible to palpation.
Hemothorax: Minor may not be noted on primary assessment. Larger will present with dyspnea, dull percussion. Possible tx: Thoracentesis, chest tube placement.
Clinical indicators of abdominal injury/trauma
§Hypoactive bowel sounds
§Absent bowel sounds (peritonitis)
Increased risk for
§Peritonitis- i.e. when hollow organ contents spill into peritoneal cavity (at risk for infection)
§Abdominal compartment syndrome- due to bleeds, organ edema, inflammation...
...Can be from blunt or penetrating trauma
Peritonitis can develop when contents of hollow organs spill into peritoneal cavity (stomach, bladder, intestines)
FYI Solid Organs: spleen, pancreas, liver, kidney, adrenal glands
Abdominal compartment syndrome can be caused by bleeding, edema of organs, third spacing from inflammation... can lead to resp. failure, kidney injury and shock.