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)
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
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:
- Legome, E. (2022, September 28). Initial evaluation and management of blunt thoracic trauma in adults. UpToDate. https://www.uptodate.com/contents/initial-evaluation-and-management-of-blunt-thoracic-trauma-in-adults
- Winkle, J. M. (2022, September 29). Initial evaluation and management of penetrating thoracic trauma in adults. UpToDate. https://www.uptodate.com/contents/initial-evaluation-and-management-of-penetrating-thoracic-trauma-in-adults
- American Academy of Pediatrics. (2021, November 1). Blast terrorism and explosions: disaster management resources. https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/blast-terrorism-and-explosions/
Respiratory Exam
Concepts Covered:
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Noninfectious Respiratory Disorder
- Intraoperative Nursing
- Infectious Respiratory Disorder
- Respiratory Disorders
- Medication Administration
- Emergency Care of the Trauma Patient
Study Plan Lessons
Acute Respiratory Distress
Rapid Sequence Intubation
ARDS causes Nursing Mnemonic (GUT PASS)
Artificial Airways
Asthma for Certified Emergency Nursing (CEN)
Chest Tube Management
General Anesthesia
Moderate Sedation
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Pneumonia
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan for Pulmonary Edema
Nursing Case Study for Pneumonia
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Propofol (Diprivan) Nursing Considerations
Respiratory Alkalosis
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Respiratory Trauma for Certified Emergency Nursing (CEN)
Thoracentesis
Tuberculosis for Certified Emergency Nursing (CEN)
Ventilator Settings