![]() ![]() How well do CPR compressions work on someone with a penetrating chest injury and hypovolemia? ![]() #38 French - inserted at the 4th or 5th intercostal space, just anterior to the midaxillary line.Ī rise in venous pressure with inspiration while breathing spontaneously, and is a true paradoxical venous pressure abnormality associated with cardiac tamponade. What size chest tube might you use to evacuate a massive hemothorax? (Some also define it as continued blood loss of 200 mL/hr for 2-4 hours- but ATLS does NOT use this rate for any mandatory treatment decisions). No, they might have a massive internal hemorrhage and be hypovolemic.īy definition, how much blood is in the chest cavity to call it a "massive hemothorax"?ġ500 mL or 1/3 or more of the patient's total blood volume. If a patient doesn't have JVD, does this mean they don't have a tension pneumo or tamponade? Percussion - hyperresonant with pnuemo, dull with hemothorax. Into the 2nd intercostal space in the midclavicular line of the affected hemithorax.įor an open pneumothorax, (sucking chest wound) air passes preferentially through the chest wall defect (least resistance) if the diameter of the defect is at least _ the diameter of the trachea.įlail chest results from multiple rib fractures - by definition this would be _ or more ribs, fractured in _ or more places.Ģ or more ribs fractured in 2 or more placesīoth tension pneumothorax and massive hemothorax are associated with decreased breath sounds on auscultation, so you can tell which it is by _. Where would you insert a large caliber needle to decompress a tension pnuemothorax? This may NOT be a pneumothorax, for intubated patients always suspect a right main-stem before attempting needle decompression. Make a 2.5 cm transverse incision through the skin and SQ tissue, careful not to injure the vessel.Ī patient arrives to the trauma bay intubated and there are absent breath sounds over the left hemithorax, where should you place your decompression needle? ![]() The saphenous vein can be accessed approximately 1 cm anterior and 1 cm superior to the medial malleolus. Where do you want to make an incision for a saphenous vein cutdown and how long should your incision be? Intraosseous infusion should be limited to emergency resuscitation and shoudl be discontinued as soon as other venous access is obtained. SUPINE, head down 15 degrees to distend neck veins and prevent embolism, only turn head away if C-SPINE HAS BEEN CLEARED FIRST. How should you position the patient before placing a subclavian or IJ line? ![]()
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