I need help figuring out what is wrong with each traumatic patient.
Patient 1: Involved in a car crash.
HR 142(weak/thready); BP 132/70; R 40 +JVD; diminished lung sounds.
Patient 2: involved in car crash
HR130(weak/thready); BP 100/90; R 24 +JVD; clear lung sounds
I think patient 1 could be having a pnuemothorax and a possible cardiac tamponade. What type of shock is patient 1 going into?
What type of shock is patient 2?
Patient 1: Involved in a car crash.
HR 142(weak/thready); BP 132/70; R 40 +JVD; diminished lung sounds.
Patient 2: involved in car crash
HR130(weak/thready); BP 100/90; R 24 +JVD; clear lung sounds
I think patient 1 could be having a pnuemothorax and a possible cardiac tamponade. What type of shock is patient 1 going into?
What type of shock is patient 2?
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Pt 1: tension pneumo on the side of diminished lung sounds. Needs a chest tube.
While cardiac tampanade is possible, it would not be considered until/unless it shows up on a CT, OR cardiac sounds are distant in the trauma room.
Tampanade SLOWS the heart, because it causes compression on the actual muscle.
The patient is not IN shock ... YET. BP is still stable. If he were to go into shock, it would be HYPOVOLEMIC due to trauma in the thorax (ie bloodloss). RR 40 simply means one lung's not working due to the pneumo. JVD is evidence of the pneumo, NOT SHOCK.
Read this:
http://www.turner-white.com/memberfile.p…
Pt 2: Hypovolemic shock. For the reason I stated above. Trauma related.
This pt is more likely to have tampanade than #1 - his volumes are low so he is in shock (BP systolic 100) + JVD w/o a lung problem. More assessment is required.
While cardiac tampanade is possible, it would not be considered until/unless it shows up on a CT, OR cardiac sounds are distant in the trauma room.
Tampanade SLOWS the heart, because it causes compression on the actual muscle.
The patient is not IN shock ... YET. BP is still stable. If he were to go into shock, it would be HYPOVOLEMIC due to trauma in the thorax (ie bloodloss). RR 40 simply means one lung's not working due to the pneumo. JVD is evidence of the pneumo, NOT SHOCK.
Read this:
http://www.turner-white.com/memberfile.p…
Pt 2: Hypovolemic shock. For the reason I stated above. Trauma related.
This pt is more likely to have tampanade than #1 - his volumes are low so he is in shock (BP systolic 100) + JVD w/o a lung problem. More assessment is required.