trauma presentation
TRAUMA AND
EMERCENCY
NURSING
BY SEELAA SEGARAN
The nursing care and management of a client with
Tension
Pneumothorax.
INTRODUCTION
ANATOMY OF
THE LUNG
DEFINATION
OF TENSION
PNEUMOTHORAX
PROGRESSIVE BUILDUP OF AIR
WITHIN THE PLEURAL SPACE
DUE TO A LUNG LACERATION AIR TO ESCAPE INTO THE PLEURAL
SPACE BUT NOT TO RETURN
'ONEWAYVALVE' EFFECT PUSHES THE MEDIASTINUM
OBSTRUCTS VENOUS RETURN =
CIRCULATORY INSTABILITY
TRAUMATIC ARREST.
SYMPTOMS
Respiratory distress
Distended neck vein
Tracheal deviation
Tachycardia
Low blood pressure
Cyanosis
Decreased lung sounds
MANAGEMENT OF A
TENSION
PNEUMOTHORAX
• Open chest wound – seal the wound with an occlusive dressing.
• Needle thoracostomy or needle compression. • Chest tube.
CASE STUDY: MR. S
DEMOGRAPHIC
DATA
Patient’s Name
: Mr. S
Age
: 35 Yrs Old
Sex
Marital Status
Religion
: Male
: Married
: Hinduism
Race
: Indian
Nationality
: Malaysian
Address
: Taman Bayu Perdana
Occupation
: Unknown
Next Of Kin
: Wife.
Allergic
: NIL
Past Medical History : NIL Past Surgical History: NIL Social History
:Non Alcoholic
Non Smoker
HISTORY FROM TRIAGE
Brought in to ED via ambulance
On cervical collar and immobilizer at right leg
Multiple abrasion wound
right leg pain, swelling, tenderness and bruising Hematoma at right temporal
H/O MVA @ 1000hrs (motorbike versus lorry)
Head on collision
Pt was a rider
Wearing helmet
LOC at scene now drowsy
ENT bleed (severe nose bleed)
Immediate action
Cervical collar
Compress
HGT
Iv access
ATT
PRIMARY
ASSESMENT
Airway - unable to maintain airway patency intubated ETT size 7.5 (for airway protection) Breathing - Tachypnea and stridor
Circulation – pulse rate : 100bpmin unresponsive capillary refill less than 3 sec no obvious bleeding noted
Disability – GCS 8 : No eyes opening (1)
:making incomprehensible sound (2)
:localizes to a painful stimulus (5)
- Pupil :3mm and equal
:
EMERCENCY
NURSING
BY SEELAA SEGARAN
The nursing care and management of a client with
Tension
Pneumothorax.
INTRODUCTION
ANATOMY OF
THE LUNG
DEFINATION
OF TENSION
PNEUMOTHORAX
PROGRESSIVE BUILDUP OF AIR
WITHIN THE PLEURAL SPACE
DUE TO A LUNG LACERATION AIR TO ESCAPE INTO THE PLEURAL
SPACE BUT NOT TO RETURN
'ONEWAYVALVE' EFFECT PUSHES THE MEDIASTINUM
OBSTRUCTS VENOUS RETURN =
CIRCULATORY INSTABILITY
TRAUMATIC ARREST.
SYMPTOMS
Respiratory distress
Distended neck vein
Tracheal deviation
Tachycardia
Low blood pressure
Cyanosis
Decreased lung sounds
MANAGEMENT OF A
TENSION
PNEUMOTHORAX
• Open chest wound – seal the wound with an occlusive dressing.
• Needle thoracostomy or needle compression. • Chest tube.
CASE STUDY: MR. S
DEMOGRAPHIC
DATA
Patient’s Name
: Mr. S
Age
: 35 Yrs Old
Sex
Marital Status
Religion
: Male
: Married
: Hinduism
Race
: Indian
Nationality
: Malaysian
Address
: Taman Bayu Perdana
Occupation
: Unknown
Next Of Kin
: Wife.
Allergic
: NIL
Past Medical History : NIL Past Surgical History: NIL Social History
:Non Alcoholic
Non Smoker
HISTORY FROM TRIAGE
Brought in to ED via ambulance
On cervical collar and immobilizer at right leg
Multiple abrasion wound
right leg pain, swelling, tenderness and bruising Hematoma at right temporal
H/O MVA @ 1000hrs (motorbike versus lorry)
Head on collision
Pt was a rider
Wearing helmet
LOC at scene now drowsy
ENT bleed (severe nose bleed)
Immediate action
Cervical collar
Compress
HGT
Iv access
ATT
PRIMARY
ASSESMENT
Airway - unable to maintain airway patency intubated ETT size 7.5 (for airway protection) Breathing - Tachypnea and stridor
Circulation – pulse rate : 100bpmin unresponsive capillary refill less than 3 sec no obvious bleeding noted
Disability – GCS 8 : No eyes opening (1)
:making incomprehensible sound (2)
:localizes to a painful stimulus (5)
- Pupil :3mm and equal
: