Pathology of chest wound

2021-01-30 12:00 AM

It is necessary to promptly treat emergency treatment even during the examination to detect an open chest wound, which requires sealing the hole in the patient's chest wall.

Reason

By knife, by bullet:  sharp injuries.

Due to the large bullet fragments or by a blunt object causing extensive chest wall broken to pieces: injured dirty.

Circulatory disorders in the open chest wound

Circulatory disorders in open chest wounds resulting from respiratory reversal and mediastinal sway leading to severe O2 deficiency, the patient's general condition changes rapidly if the perforation is not immediately blocked. chest back. After sealing the wound, the patient returned to the disorders such as in closed-chest trauma. In addition, it is necessary to pay attention to distant lesions in the path of the bullet or shrapnel, ball bombs ... these injuries make the patient's condition worse and the diagnosis and treatment more complicated.

Diagnose

Principles of examination and diagnosis

Gentle examination.

Need a quick, comprehensive examination without missing thoracic lesions and external combined lesions.

It is necessary to promptly treat emergency treatment even during the examination to detect an open chest wound, which requires sealing the hole in the patient's chest wall.

Need regular monitoring every hour for proper diagnosis and treatment.

Examination

Initial visit

Assess respiratory failure.

Evaluate the condition of a chest injury.

Detect coordinated injury.

Clinical symptoms

Severe chest pain.

Expression of lack of gas.

Pale or pale, sweating, rapid breathing.

Cardiovascular manifestations: tachycardia, blood pressure drop, fluctuation, arrhythmia, floating neck veins.

Respiratory disorders: Sputum deposition, haemoptysis, tachycardia, reversed respiratory drainage.

Chest X-ray

If the patient's conditions permit, a new chest X-ray is indicated. Need to see:

Chest wall condition.

There are signs of compression in the pleura: Due to gas, fluid.

There is a deflected mediastinal drain.

Enlarged mediastinal size.

Diaphragm condition.

Other necessary tests: blood gas, pH, pO2, pCO2, BE, SaO2.