Professional Documents
Culture Documents
Chapter 27
Chapter 27
Cognitive Objectives (1 of 2)
• General impression
– Quickly evaluate ABCs.
– Difficulty speaking may indicate several
problems.
– Patients with significant chest injuries will look
sick.
• Airway and breathing
– Ensure that patient has a clear, patent airway.
– Protect the spine.
– Inspect for DCAP-BTLS.
Inspection
• Decreased breath sounds usually indicate
significant damage to a lung.
• If both sides of chest do not have equal rise and
fall, chest muscles have lost ability to work
properly.
• If one section of chest moves in opposite direction
from the rest of the chest (paradoxical motion), this
is a life threat.
Immediate Interventions
• Apply an occlusive dressing to any penetrating chest
injury.
• Stabilize paradoxical motion with a large bulky
dressing and 2'' tape.
• Apply oxygen via nonrebreathing mask at 15 L/min.
• Provide positive pressure ventilations if breathing is
inadequate.
Circulation
• Assess patient’s pulse.
• Consider aggressive treatment for shock.
• Internal bleeding can quickly cause death.
Transport Decision
• Rapidly transport if patient has problems with
ABCs.
• Pay attention to subtle clues.
– Skin signs
– Level of consciousness
– Sense of impending doom
• You ensure that his airway is open. You are the provider
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