Chest and abd trauma ppt
- 1. A N A P P R O A C H T O C H E S T A N D A B D O M I N A L T R A U M A A P R E S E N T A T I O N B Y T H E C A S U A L T Y C R E W
- 2. F L A I L C H E S T • OCCURS WHEN SEGMENT OF FRACTURED RIBS ARE SEPARATED FROM THE CHEST WALL • NOTE THE PARADOXICAL MOVEMENT • MAIN AIM OF TX IN CASUALTY IS PAIN CONTROL AND ICD • PAIN CONTROL VIA INTERCOSTAL NERVE BLOCK • SURGEONS AND ICU MUST BE INVOLVED EARLY, OFTEN PTS REQUIRE VENTILATION • OFTEN THERE ARE ASSOCIATED LUNG CONTUSIONS, HAEMOPNEUMOTHORAX AND CARDIAC CONTUSIONS
- 3. F I N D T H E F L A I L S E G M E N T L E T S T R Y A N X R A Y
- 5. L O O K C A R E F U L L Y L E T S T R Y O N E M O R E
- 7. V E R Y S U B T L E L A S T O N E
- 9. W H A T I S T H E D X ? P T W I T H S E V E R E A S T H M A
- 10. T E N S I O N P N E U M O T H O R A X • NOTE THE TRACHEAL DEVIATION • ABSENCE OF LUNG MARKINGS LEFT • DEEP SULCUS SIGN LEFT
- 12. W H A T S T H E D X ? P T W I T H A S T A B T O L E F T C H E S T W A L L
- 13. A N E A S Y P N E U M O T H O R A X T O S E E T H A T S R I G H T
- 14. H E M O T H O R A X F F G S T A B A L S O A N E A S Y O N E
- 15. S A F E Z O N E F O R I C D V E R Y I M P O R T A N T
- 16. S I G N S O F S T A B H E A R T • DISTENDED NECK VEINS AS SEEN HERE • MUFFLED HEART SOUNDS • LOW BP • CALLED BECKS TRIAD • EVEN ONE OF THESE SHOULD AROUSE SUSPICION OF STAB INTO HEART
- 17. H O P E F U L L Y Y O U W I L L S E E O N E S O M E T I M E N O T P E R F O R M E D R O U T I N E L Y I N O U R C A S U A L T Y E M E R G E N C Y T H O R A C O T O M Y
- 18. M E A N S F R E E A I R I N P E R I T O N E A L C A V I T Y F R E E A I R U N D E R D I A P H R A G M
- 19. W H A T I S T H I S C A L L E D W H A T D O E S I T I N D I C A T E C H I L D F E L L A N D I N J U R E D A B D O M E N
- 20. D O U B L E W A L L S I G N • AIR IS PRESENT ON BOTH SIDES OF THE INTESTINAL WALL • INDICATES FREE AIR IN THE PERITONEAL CAVITY
- 21. W H A T I S T H I S C A L L E D I N F A N T W I T H S P O N T A N E O U S O N S E T P A I N A N D P E R I T O N I T I S
- 22. F O O T B A L L S I G N • ALSO A SIGN OF FREE AIR IN THE PERITONEAL CAVITY
- 23. C A N Y O U S E E T H E F O O T B A L L A N D T H E D O U B L E W A L L S U P I N E V I E W
- 25. T R A U M A T O T H E A B D O M E N • PERITONITIS IS MUCH EASIER TO ELICIT IN ADULTS • MOST INTERNS AND JUNIOR MO’S CAN IDENTIFY OR HAVE A HIGH INDEX OF SUSPICION FOR IT • MUCH MORE DIFFICULT IN CHILDREN ,TODDLERS AND INFANTS • ANY CHILD WITH ANY TRAUMA TO ANY PART OF THE BODY MUST STILL HAVE THEIR ABDOMEN CHECKED, ANY SUSPICION OF INJURY SHOULD MEAN THEY HAVE AN X-RAY DONE
- 26. O F T E N A S S O C I A T E D W I T H I N T R A B D O M I N A L A N D S P I N A L I N J U R Y S E A T B E L T I N J U R Y
- 27. V E R Y C O M M O N W I T H S E A T B E L T I N J U R Y C H A N C E F R A C T U R E S
- 29. G R E Y - T U R N E R & C U L L E N S I G N • SIGN OF RETROPERITONEAL HAEMORRHAGE • SEEN IN TRAUMA, HAEMORRHAGIC PANCREATITIS, LEAKING AORTIC ANEURYSM, RUPTURED ECTOPIC PREGNANCY