Lecture on Chest Injuries and Emergency Medical Response

Definitions and Concepts

• Open vs. Closed Injuries
  • Open: Exposed to the outside world, skin is punctured.
  • Closed: Not exposed externally.

Causes of Open Chest Injuries

• Lacerations
• Gunshots
• Stabbing or penetrating injuries

Concerns with Open Chest Injuries

• Air accumulation where it shouldn't be (e.g., pneumothorax)

Closed Chest Injuries

• Can cause pulmonary and cardiac contusions (lung and heart bruises)

Medical Terms

• Hemoptysis: Coughing up blood; common in internal chest injuries.

Assessing Chest Injuries

• Importance of exposing injuries for proper assessment, even if minor.
• Palpating the injury without causing further harm.
• Use of CMS (Circulation, Motor function, Sensory function) assessment.

Breathing and Respiratory Concerns

• Short, shallow breaths due to pain can reduce tidal volume.
• Monitoring ABCs (Airway, Breathing, Circulation) is critical.
• Use high-flow oxygen for shallow breathing.

Pneumothorax

• Air accumulation in the pleural cavity causing lung collapse.
• Often caused by penetrating injuries or broken ribs.
• Tension Pneumothorax: A severe form causing mediastinum shift, decreased cardiac output, and tracheal deviation.
• Simple Pneumothorax: Not causing cardiac complications.
• Spontaneous Pneumothorax: Occurs without trauma, common in tall, skinny young men.

Hemothorax

• Accumulation of blood in the thorax.
• Caused by bleeding from rib-associated veins or arteries.

Signs and Symptoms of Pneumothorax

• Difficulty breathing, unilateral chest rise, decreased SpO2, increased heart rate, decreased blood pressure, absent/diminished lung sounds.

Treatment of Open Chest Wounds

• Use of chest seals or occlusive dressings.
• Importance of identifying entry and exit wounds.

Flail Chest

• Definition: Three or more consecutive ribs broken in more than one spot.
• Causes a floating section of the chest wall and paradoxical movement.
• Treated with positive pressure ventilation.

Complications and Additional Conditions

• Cardiac Tamponade: Blood in the pericardium compresses the heart (Beck's Triad: JVD, muffled heart tones, narrowing pulse pressure).
• Traumatic Asphyxia: Sudden compression of the chest; high fatality rate.
• Commodio Cordis: Blunt chest impact causing cardiac arrest, typically in healthy individuals.

Emergency Response

• Recognition and rapid transport to hospital.
• In the field: identification of serious conditions, applying high-flow oxygen, managing open wounds, and involving advanced life support if needed.

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These notes provide a comprehensive overview of the lecture content focusing on chest injuries and relevant emergency response procedures.