tailieunhanh - Lecture Mosby's paramedic textbook (4th ed) - Chapter 42: Chest trauma

In this chapter you will learn about the following: Describe the basic structure of the legal system in the United States, relate how laws affect the paramedic’s practice, list situations that a paramedic is legally required to report in most states, describe the four elements involved in a claim of negligence, describe measures paramedics may take to protect themselves from claims of negligence. | 9/11/2012 1 Chapter 42 Chest Trauma 2 Learning Objectives • Discuss mechanism of injury associated with chest trauma. • Describe the mechanism of injury, signs and symptoms, and management of skeletal injuries to the chest. • Describe the mechanism of injury, signs and symptoms, and prehospital management of pulmonary trauma. 3 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1 9/11/2012 Learning Objectives • Describe the mechanism of injury, signs and symptoms, and prehospital management of injuries to the heart and great vessels. • Outline the mechanism of injury, signs and symptoms, and prehospital care of the patient with esophageal and tracheobronchial injury and diaphragmatic rupture. 4 Skeletal Injury • May be caused by blunt and/or penetrating trauma • Thoracic cage protects vital organs within chest – Prevents collapse of thorax during respiration 5 Skeletal Injury • Skeletal components of the thoracic cage – 12 thoracic vertebrae – 12 ribs (with their associated costal cartilages) – Sternum • Superior 7 ribs (true ribs) are attached by cartilage to sternum • Inferior 5 ribs (false ribs) articulate with vertebrae, but do not attach directly to sternum • Ribs 8, 9, 10 are joined to common cartilage, which is attached to sternum • Ribs 11 and 12 are “floating ribs,” no attachment to sternum 6 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2 9/11/2012 Skeletal Injury • Sternum has three parts – Manubrium • Jugular notch is located at superior end • Joins body of sternum at sternal angle (angle of Louis) – Body – Xiphoid process • Clavicles are part of appendicular skeleton – Attach upper limbs to the axial skeleton – Made at sternoclavicular joint between clavicles and sternum 7 8 Clavicular Fractures • Clavicle accounts for 5 percent of all fractures and is most frequently fractured bone in children – Isolated clavicular .