Presentation
The classic triad of distended neck veins, low blood pressure, and muffled heart tones is present in less than a third of patients. Neck veins may not be distended if hypovolemia is present, and muffled heart tones are often not present. [madsci.com]
Initiate ALS interventions such as O2, IV, cardiac monitoring and fluid volume resuscitation if signs of shock are present. [medictests.com]
Most cases present shortly after catheter manipulations, and the diagnosis is based on the temporal association between the intervention and the immediate onset of symptoms. [appliedradiology.com]
Patients that do survive to hospital presentation present with signs of profound hypotension or pericardial tamponade. [aast.org]
In contrast, our patient presented with very misleading symptoms of pulselessness and loss of sensibility on her left side. Taken together with her history of hypertension type B aortic dissection was suspected. [academic.oup.com]
Respiratoric
- Respiratory Insufficiency
Lung hemorrhage and pulmonary edema leads to impaired gas exchange and respiratory insufficiency. Lesions may progress over hours to days (e.g. peak at 72 hours then resolve over 7 days) then gradually improve. [lifeinthefastlane.com]
The diagnosis of ruptured diaphragm is frequently missed in the acute phase because of the presence of hypovolaemic shock, respiratory insufficiency, visceral injuries or coma. [worldwidewounds.com]
Cardiovascular
- Tachycardia
[…] decreased venous return and kinking of great vessels resulting in obstructive shock Have a high index of suspicion in any tachycardic and hypotensive patient — clinical features may not be obvious Recognition Anxiety and agitation Respiratory distress Tachycardia [lifeinthefastlane.com]
Tachycardia and hypotension will become profound, followed by decreased level of consciousness. [medictests.com]
Examining the expectoration may help localize the source of bleeding. 4, 17, 18 The physician should record vital signs, including pulse oximetry levels, to document fever, tachycardia, tachypnea, weight changes, and hypoxia. [aafp.org]
The EKG may be usually normal, but may demonstrate a rapid heart rate, a sinus tachycardia (heart rate > 100 bpm). [medicinenet.com]
AAST Injury Scale: Cardiac Injuries Grade I Blunt cardiac injury with minor EKG abnormality (non specific ST of T wave changes, premature atrial or ventricular contractions, or persistent sinus tachycardia Blunt or penetrating pericardial wound without [aast.org]
- Vascular Disease
You are more likely to have vascular disease as you get older. [icdlist.com]
Neurologic
- Dizziness
The risk of pulmonary embolism increases with age Symptoms include chest pain, dizziness, and rapid breathing The risk of pulmonary embolism is high for individuals who have had a blood clot in the leg or arm In rare cases, a pulmonary embolism can be [medicalnewstoday.com]
Workup
The workup may include: Physical exam - The physician checks blood pressure, feels the body for masses and listens to blood flow sounds. [innerbody.com]
Treatment
Treatment: Rapid fluid resuscitation while awaiting surgical repair. [madsci.com]
Treatment: treatment for a tension pneumothorax is needle decompression, a skill typically available only to ALS providers. [medictests.com]
Anticoagulation medication is the treatment for pulmonary embolism, and the patient may be required to continue treatment for a minimum of 3 to 6 months. [medicinenet.com]
Another treatment option is hyperbaric oxygen therapy. This is a painless treatment during which you occupy a steel, high-pressurized room that delivers 100 percent oxygen. [healthline.com]
Definitive treatment has traditionally been immediate operative repair, but recent experience suggests that endovascular stent placement is now the treatment of choice. [msdmanuals.com]
Prognosis
The prognosis of pneumothorax depends on its cause. For a spontaneous pneumothorax, there is an increased risk for another collapsed lung in the future. [emedicinehealth.com]
Cardiac rupture has the worst prognosis at 20 percent survival rate. Thoracic Great Vessel Injury This includes injuries to the main artery coming out of the heart—the aorta as well as its branches. [autoaccident.com]
It was decided to perform a left-sided diagnostic thoracotomy given the dismal prognosis of the patient without surgical intervention. Fig. 1 CT scan showing hematoma around the descending thoracic aorta (closed arrow). [academic.oup.com]
Prognosis For the great majority of patients with blunt chest trauma, outcome and prognosis are excellent. Most (>80%) require either no invasive therapy or, at most, a tube thoracostomy to effect resolution of their injuries. [emedicine.medscape.com]
BCI should be highly suspected when these other injuries are presents, and these other injuries may greatly affect the patients overall prognosis. [aast.org]
Etiology
Etiology The differential for etiologies of pulmonary artery aneurysms can be broad. [radiopaedia.org]
Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]
Etiology With blunt trauma, the usual mechanism is a severe deceleration injury; patients often have multiple rib fractures, 1st and/or 2nd rib fractures, or other manifestations of severe chest trauma. [msdmanuals.com]
MASSIVE HEMOPTYSIS The mortality rate from massive hemoptysis depends on the bleeding rate and etiology. [aafp.org]
Epidemiology
INTRODUCTION AND EPIDEMIOLOGY Blunt thoracic injuries account for up to one fourth of all injury-related deaths. 1 The mechanism of injury and severity of tissue damage predict the clinical course and outcome. 2 Injuries that do not violate the pleura [accessmedicine.mhmedical.com]
A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. [books.google.it]
Epidemiology of chest trauma. Surg Clin North Am. 1989 Feb. 69(1):15-9. 3. Mancini MC. Blunt Chest Trauma. Retrieved 15 November 2015. 4. Champion HR et al. The Major Trauma Outcome Study: establishing national norms for trauma care. [ems1.com]
Epidemiology Trauma is responsible for more than 100,000 deaths annually in the United States. [1] Estimates of thoracic trauma frequency indicate that injuries occur in 12 persons per 1 million population per day. [emedicine.medscape.com]
ARDS Myocardial contusion Definition and epidemiology direct traumatic myocardial damage without traumatic involvement of coronary arteries common in blunt trauma but difficult to diagnose tends to occur in acceleration/deceleration and crush/compression [aic.cuhk.edu.hk]
Pathophysiology
Pathophysiology Complete rupture causes rapid death by exsanguination. [msdmanuals.com]
Pathophysiology The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. [emedicine.medscape.com]
[…] death, Pathology, 1990, vol. 22 (pg. 1 - 4 ) [6] Pulmonary artery rupture associated with the Swan-Ganz catheter, Chest, 1995, vol. 108 (pg. 1349 - 1352 ) [7] Pulmonary hypertension associated with COPD, Crit Care, 2001, vol. 5 (pg. 286 - 298 ) [8] Pathophysiology [academic.oup.com]
Prevention
Treatment Exercise is one of the best ways to prevent pulmonary embolism. [medicalnewstoday.com]
Treatment Treatment of aneurysm has several goals: Prevent growth. Prevent rupture or leaking. Prevent or treat damage caused by the aneurysm to other body structures (for example, the nerves). Preserve quality of life. [innerbody.com]
Anticoagulation Anticoagulation prevents further growth of the blood clot, preventing more lung tissue from being affected. The body has complex mechanism to form blood clots to help repair blood vessel damage. [medicinenet.com]
According to the Centers for Disease Control and Prevention (CDC), the most common fatal injury for people in combat who survive blast injuries is “blast lung.” [healthline.com]