EMT chapter 29- Chest Injuries

Children are often "belly breathers" because _______.

: their intercostal muscles are not developed

What blood vessels can be lacerated by a fractured rib?

Aorta

You are assessing a patient and notice he has a collapsed jugular vein. What does this indicate?

Hemothorax

You are assessing a patient who sustained a blunt force chest injury during a motorcycle accident. There are no obvious signs of external bleeding, but the patient is hypovolemic and there are decreased breath sounds on the left side. What should you suspect?

Hemothorax (a collection of blood in the space between the chest wall and the lung)

What is ventilation?

The body's ability to move air in and out of the chest and lung tissue

A flail chest occurs when:

a segment of the chest wall is detached from the thoracic cage.

What is most likely to cause immediate death?

aortic rupture

The thoracic cavity is separated from the abdominal cavity by the:

diaphragm

You respond to a residence for a 40-year-old female who was assaulted by her husband; the scene has been secured by law enforcement. Upon your arrival, you find the patient lying supine on the floor in the kitchen. She is semiconscious with severely labored breathing. Further assessment reveals a large bruise to the left anterior chest, jugular venous distention, and unilaterally absent breath sounds. As your partner is supporting her ventilations, you should:

immediately request ALS support

You arrive at the scene of a major motor vehicle crash. The patient, a 50-year-old female, was removed from her vehicle prior to your arrival. Bystanders who removed her state that she was not wearing a seatbelt. The patient is unresponsive, 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 patient has experienced a:

laceration of the aorta.

If a patient 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.

what are you likely to see in flail chest?

paradoxical motion

A spinal cord injury at the level of C7 would MOST likely result in:

paralysis of the intercostal muscles.

In order to avoid exacerbating a patient's injury, it is especially important to use extreme caution when providing positive-pressure ventilation to patients with a:

pneumothorax (air between lung and chest wall casing collapsed lung)

A man called EMS 12 hours after injuring his chest. Your assessment reveals a flail segment to the right side of the chest. The patient is experiencing respiratory distress and his oxygen saturation is 78%. His breath sounds are equal bilaterally and his jugular veins are normal. You should suspect:

pulmonary contusion.

What is the best position in which to place a patient when you want to assess for jugular vein distention?

sitting at a 45 degree angle

In which condition is it recommended you use positive-pressure ventilation?

Flail chest

When a patient sustains a spinal cord injury above the C3 region, what is likely to happen?

Loss of the ability to breathe due to loss of ability of phrenic nerves to function

You are treating a patient who fell hard on her right side when she fell off a bike. Exposure of the patient's chest reveals a large bruise on the lateral aspect of the right side of the chest. When you palpate the area, the patient yells out in extreme pain and states that she cannot take a deep breath. What condition should you suspect?

Rib fractures