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Assistant Professor
Department of Surgical Disciplines
All India Institute of Medical Sciences
25-11-2015
Objective:
Burden of Chest Trauma.
Penetrating
Explosion related
25-11-2015
Background:
Significant cause of mortality.
(A)Hypovolemia(Blood Loss)
25-11-2015
Issues in chest Trauma : Hypoxia,
Hypercarbia & Acidosis
Hypercarbia: Inadequate ventilation.
25-11-2015
Basic principle of Management:
Primary survey
Definitive care.
25-11-2015
Primary Survey
Airway with cervical spine protection
Disability: GCS
25-11-2015
Tension Pneumothorax: Etiology
Mechanical Ventilation with PPV in patients with
visceral pleural injury.
CVP Insertion
Iatrogenic
Esophageal Endoscopy
Thoracic Spine #
Needle
Thoracostomy in
2nd I.C.S in M.C.L.
Chest tube insertion in 5th
I.C.S in M.A.L.
25-11-2015
CXR- Pneumothorax.
JPNATC, AIIMS
25-11-2015
How to read CXR:ABCDEF
Airway- Trachea
Cardiac Shadow
Diaphragm
25-11-2015
Open Pneumothorax
(Sucking chest wound)
Sucking wound
25-11-2015
T/t of openPneumothorax:
Apply Sterile Occlusive dressing over the defect
Open wound
25-11-2015
Flail Chest & PulmonaryContusion:
If 2 or more ribs fractured in
2 or moreplaces.
Flail segment don't have
bony continuity.
Paradoxical movement of flail
segment with underlying
normal chest movement .
High association with Pulmonary
Contusion
25-11-2015
Flail Chest & PulmonaryContusion
Asymmetrical & uncoordinated chest movement
CXR
ABG
CT
25-11-2015
Flail Chest & Pul. Contusion -M/n
Better to admit- ICU ( Intubation & Ventilation)
25-11-2015
Massive Haemothorax: Dx
Restricted Chest Movement(Inspection)
Dullness to Percussion
Chest X-Ray
ABG
CT.
25-11-2015
Massive Haemothorax: M/n
Follow the ABC.
25-11-2015
Penetrating Chest Trauma:
25-11-2015
Operative finding: Lacerated Lung
25-11-2015
E-FAST
Lung USG is more sensitive than CXR for
Pneumothorax
25-11-2015
To detectPneumothorax??
A Line
B Line
Seashore sign
Barcode sign
Lung Point.
25-11-2015
E-FASTin ChestTrauma
25-11-2015
Bat’s Sign: Normal Finding: BMode
25-11-2015
E-FAST in Chest Trauma: Bmode
25-11-2015
Seashore sign & Barcodesign
Barcode sign
Seashore sign
Pneumothorax- Find
Normal Lung
the lung point
25-11-2015
Lung Point: Pneumothorax
Lung Point
Barcode sign
25-11-2015
Chest Trauma- Follow ABC
Lung Sliding= Bat’s Sign, Pleural Line
Absent & Lung Sliding