Respiratory Trauma for Certified Emergency Nursing (CEN)

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Included In This Lesson

Study Tools For Respiratory Trauma for Certified Emergency Nursing (CEN)

Tension Pneumothorax (Image)
Atelectasis Pathochart (Cheatsheet)
Atelectasis (Image)
Example Care Plan_Pneumothorax/Hemothorax (Cheatsheet)
Left Hemothorax Xray (Image)
ARDS Pathochart (Cheatsheet)
ARDS Ventilation (Cheatsheet)
CT Scan Pulmonary Contusions (Image)
Pulmonary edema treatment (Mnemonic)
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Outline

Respiratory Trauma

 

Definition/Etiology:

Blunt, penetrating and blast trauma can all cause swelling of lung tissue and compromised gas exchange (pulmonary contusion, edema, and ARDS).

Mechanical problems compromising lung filling:

  • Fracture of chest wall bones (flail segment)
  • Hemothorax
  • Pneumothorax
  • Tension pneumothorax

 

Pathophysiology:

Compression of lung / alveoli from tension pneumothorax / atelectasis / hemothorax.

 

Compromised gas exchange from pulmonary edema / ARDS / pulmonary contusion.

Blast injury–

  • Primary: blast wave of air damages alveoli
  • Secondary: shrapnel hits chest
  • Tertiary: chest wall can hit stationary objects

 

Clinical Presentation:

  • Dyspnea
  • Low oxygen saturation (can develop late)
  • Crepitus
  • Decreased lung sounds
  • Abnormal movement of chest wall
  • Deviated trachea

 

Collaborative Management:

  • Supplemental oxygen for all
  • Needle decompression if tension
  • Flutter valve dressing if penetrating trauma
  • Chest thoracostomy tube if hemo and/or pneumo
  • CXR/CT
  • Collaborate with respiratory therapy
  • Arterial blood gasses

 

Evaluation | Patient Monitoring | Education:

  • Continuous oxygen saturation
  • Monitor output of chest tube
  • Continuous cardiac monitoring
  • Be alert for late changes of pulmonary edema and ARDS

 

Linchpins: (Key Points)

  • Gas exchange is the goal
  • Understand P:F ratio
  • Watch for development of tension
  • Late edema / ARDS can occur

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

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