EMT Chapter 34 Final Review

The EMT shows that he understands the difference between a pneumothorax and a tension pneumothorax when he makes the statement?

"A tension pneumothorax causes cardiac output to decrease; a simple pneumothorax does not affect cardiac output" (Shifts the mediastinum and compress the uninjured lung and heart.)

A patient was stabbed in the right anterior chest and is in obvious respiratory distress. As you perform the secondary assessment, which of the following signs/symptoms would concern you that she is suffering from a tension pneumothorax?

Absent breath sounds on the right, distended neck veins, tracheal deviation to the left.

A patient has sustained an injury to his mediastinum. Based on the anatomy of his chest, which one of the following structures has been injured?

Esophagus

A 23 year old female has been involved in a serious motor vehicle collision. Which assessment finding best indicates she has a flail segment?

Parodoxical chest wall movement.

A middle aged male has been stabbed once in the left anterior chest. his airway is paten, respirations tachypneic, pulse weak and rapid, and skin cool and diaphoretic. Breath sounds are clear and equal bilaterally. The vital signs are: pulse 140, respirations 24, blood pressure 100/78 mmHg, and SpO2 96% on supplemental oxygen. Given this presentation, you would have a high index of suspicion for:

Pericardial Tamponade (Tend to occur from penetrating wounds to the heart. narrow pulse pressure, tachycardia and signs of shock. )

Damage to tissues of what thoracic structures will cause impairment of ventilation and pneumothorax?

Pleural membranes

Assessment findings of a patient ejected from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 at 94%. Breath sounds are clear and equal bilaterally. The segment has been stabilized, and you are prepared to start positive pressure ventilation. Given these assessment findings, what type of injury underlying the flail segment is your primary concern?

Pulmonary Contusion (the bleeding separates the alveoli from the capillaries.)

You suspect a trauma patient to be suffering from a hemothorax to the left lung. What assessment findings would reinforce this suspicion?

Respiratory distress and the signs and symptoms of shock (Blood compresses the lung)

The EMT's primary and first concern with any open injury to the chest is:

Stopping air entry

An alert and oriented young male fell 5 feet from a stage, impacting a metal railing with the right side of his chest, just under the armpit. The primary assessment is negative for life threats, although he does complain of very painful breathing and has remarkable tenderness and crepitus over the 5th rib laterally in this area. Throughout care, what actions is essential to perform?

monitor breath sounds