3 INTRODUCTIONEach year there are nearly 150,000 accidental deaths in the United States25% of these deaths are a direct result of thoracic traumaAn additional 25% of traumatic deaths have chest injury as a contributing factor
4 MORTALITY OF CHEST WOUNDS DURING MILITARY CAMPAIGNS
5 REASONAs a Ranger First Responder, you must be able to identify and treat penetrating trauma to the chest!
10 OPEN PNEUMOTHORAXDevelops when penetration injury to the chest allows the pleural space to be exposed to atmospheric pressure - “Sucking Chest Wound”Q- WHAT MAY CAUSE A SCW?Examples Include:GSW, Stab Wounds, Impaled Objects, Etc...
11 LARGE VS SMALLSeverity is directly proportional to the size of the woundAtmospheric pressure forces air through the wound upon inspiration
12 S/S: OPEN PNEUMOTHORAX Shortness of Breath (SOB)PainSucking or gurgling sound as air moves in and out of the pleural space through the wound
13 MANAGEMENT OF SCW Tension Pneumothorax Apply an Asherman Chest Seal Occlusive dressing with a release valveObserve for development of aTension Pneumothorax
25 NEEDLE THORACENTESISLocate 2nd or 3rd Intercostal Space at the Midclavicular LineInsert a 14g needle/catheter over the top of the rib (“VAN”) into the pleural spaceListen for air escape (WHOOSH!)Leave the catheter in placeReassess
28 SUMMARY Reviewed anatomy and physiology of the chest Discussed causes of trauma to the chestSigns, symptoms, and emergent management of:OPEN PNEUMOTHORAXAsherman Chest SealTENSION PNEUMOTHORAXNeedle Thoracentesis