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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

282
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
282
Flail Chest-I01:24

Flail Chest-I

327
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
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Chest Physiotherapy01:24

Chest Physiotherapy

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Chest Physiotherapy (CPT) is a therapeutic technique used in respiratory care to improve ventilation, clear bronchial secretions, and enhance the efficiency of respiratory muscles. This therapy includes three primary procedures: postural drainage, percussion, and vibration. It can be performed on spontaneously breathing patients and those who are intubated and mechanically ventilated.
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
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Pneumothorax-II01:27

Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

70
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Related Experiment Video

Updated: Oct 13, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Improving Blunt Chest Wall Injury Outcomes: Introducing the PIC Score.

Shawn M Terry1, Kimberly A Shoff, Mark L Sharrah

  • 1Departments of Trauma and Critical Care Surgery (Dr Terry) and Trauma Services (Ms Shoff and Mr Sharrah), WellSpan Health-York Hospital, York, Pennsylvania.

Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses
|November 12, 2021
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Summary

The PIC Protocol and PIC Score significantly reduced unplanned ICU admissions for blunt chest wall injury patients. This continuous assessment tool effectively guides care and predicts pulmonary decline.

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Area of Science:

  • Trauma Surgery
  • Pulmonary Medicine
  • Critical Care

Background:

  • Nonintubated patients with blunt chest wall injuries require effective management strategies.
  • A Level I trauma center developed the PIC Protocol and PIC Score to enhance care.
  • The protocol emphasizes continuous assessment of pain, incentive spirometry, and cough ability.

Purpose of the Study:

  • To decrease unplanned intensive care unit (ICU) admissions for blunt chest wall injury patients.
  • To evaluate the impact of the PIC Protocol and PIC Score on ICU length of stay, ventilator days, and hospital stay.
  • To assess effects on in-hospital mortality and discharge destination.

Main Methods:

  • Retrospective cohort study comparing patients before and after protocol implementation.
  • The PIC Protocol included screening, a power plan, the PIC Score tool, communication boards, and patient education.
  • Statistical analysis used independent-samples t tests and Pearson's χ2, with p < .05 as the significance level.

Main Results:

  • A total of 1,036 patients were analyzed (501 control, 535 PIC group).
  • Unanticipated escalations of care for acute pulmonary distress decreased from 3% to 0.37% with the PIC Protocol.
  • A fall in the PIC Score by 3 points over 8 hours predicted pulmonary decline.

Conclusions:

  • The PIC Protocol and PIC Score are user-friendly and cost-effective.
  • These tools effectively guide the management of blunt chest wall injury patients.
  • The protocol demonstrated a significant reduction in adverse pulmonary events.