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
Concepts Covered:
- Noninfectious Respiratory Disorder
- Respiratory System
- Terminology
- Infectious Respiratory Disorder
- Respiratory
- Respiratory Emergencies
- Emergency Care of the Respiratory Patient
- Emergency Care of the Trauma Patient
Study Plan Lessons
Respiratory Course Introduction
Respiratory Structure & Function
Respiratory Terminology
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Respiratory Functions of Blood
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Alkalosis
Respiratory Trauma for Certified Emergency Nursing (CEN)
Respiratory Trauma Module Intro