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Trauma

CHEST TRAUMA

Signs and Symptoms of Chest Trauma
• Difficulty Breathing: Cyanosis / Pursing of lips / Accessory muscle involvement
• Rapid Respirations with SPO2 decreasing or <93% (Trauma: In Flight and on O2)
• Flail Chest
• Unequal Rise and Fall
• Open Wound / Impalement Over Thorax
• Penetrating Abdominal Wound
• Bruising Across Chest or Base of Neck

• Subcutaneous Emphysema or Deviated Trachea
Continued From:
Tactical Evacuation Guideline
Penetrating Penetrating vs. Blunt Trauma Blunt

Respiratory Distress
OPEN Chest Wound or • SpO 2 <93% (On O 2 & Flail Chest?
IMPALEMENT? Patent Airway)
NO • Use of Accessory YES NO
YES Muscles
• Seal Open Wound (vented • Unequal Rise and Fall PAIN CONTROL
occlusive chest seal) • Cyanosis / Pursed lips Consider:
• Stabilize Impalement • SOB / Can’t speak in Endotracheal
Keep high index of concern for complete sentences Intubation
development of • Wheezing / Rhonchi / Pos P Ventilation
Hemo-pneumothorax Rales / Absent Breath
Sounds
Signs of Burp Chest Seal Signs of
pneumo / YES and/or Needle YES pneumo /
hemothorax Thoracostomy hemothorax
Consider Controlled Descent
Maintain High Assess response: NO
O
Index of Suspicion NO • SppO 2 >93%
2
• Improved RR
for Intra- • Equal Rise & Fall
Abdominal and
retro-peritoneal REPEAT NEEDLE Consider
bleeding in all THORACOSTOMY as needed! finger/tube
penetrating Chest thoracostomy
Injuries! Failing to
Improve
Controlled Descent as able
Return to:
Tactical Evacuation Consider:
Finger / Tube Thoracostomy
Guideline (Last resort and OUT of options)
Consider:
SPINAL IMMOBILIZATION

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