5 part of trauma
-head(most severe cases need many types of doctor)
-neck
-extremity(most frequent cases)
-abdomen
-pelvic
center of emergency in moscow
-metro сухаревькая
type of trauma
-open trauma (10%)
-close trauma (90%)
classification of chest trauma
-internal organ involvement
1.with ribs involvement(53%)
2.w/o ribs involvement (47%)
-no internal organ involvement
1.w ribs involment(19%)
2.w/o ribs involvement (8%)
what is flaily chest?
Complication?
1.pneomothorax
2.hemothorax
3.pneumohemathorax
4.lesion of organ
-liver
-spleen
-kidney
-diaphragm
organ trauma frequency
1.lung 90%
2.heart 8%
3.diaphragm 4%
4.large vessel 3%
5.bronchus 1.5%
6.trachea 1%
symptoms
1.pneumathorax(can make diagnoais by palpation-lienek's idea)
2.emphysema
3.hemothorx
4.pneumothorx
how to examine the patient?
1.position of the patient
2.color skin on trauma area
3.deformation
4.crepitation
5.skin lesion
how to make diagnosis?
1.x-ray(gold standard
2.puncture(when there is fluid )
3.meningealscopy,thoncoscopy
4.CT and MRI
acute lung lesion
-direct
yshib
internal hematoma
razrez
segmet,lobe
-mix
-indirect
fat emboli(dangerous-can go to brain lead to stroke)
repiratoey distress syndrom
edema(inrstitial alveolar)
what is index oxygenation?
Pa02/fi02
arterial oxygen /pumonary oxygen
if fi02 is more than 60%
How to treat?
1.stabilization of chest tissue
2.ventilatory help
3.nitrogen oxygen-vasodilator
what is polyporphine?
Synthetic polypoephine
2.emphysema
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