Western Trauma Association critical decisions in trauma: Lung injury

Allyson M Hynes1, John P Kuckelman, Raul Coimbra

  • 1Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI (A.M.H., M.A.B.); Department of Thoracic Surgery, Madigan Army Medical Center, Tacoma, WA (J.P.K.); Department of Surgery, Division of Acute Care Surgery, Riverside University Health System, Moreno Valley, CA (R.C.); Department of Surgery, Division of Acute Care Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA (K.L.B.); Department of Surgery, Division of Acute Care Surgery, University of Florida Health, Gainesville, FL (C.A.C.); Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Keck School of Medicine of the University of Southern California, Los Angeles, CA (K.I., M.A.S.); Department of Surgery, Division of Trauma, Surgical Critical Care and Acute Care Surgery, The University of Arizona College of Medicine Phoenix, Phoenix, AZ (N.F.K.); Department of Surgery, Division of Trauma and Surgical Critical Care, University of Tennessee Health Science Center, Memphis, TN (A.J.K.); Department of Surgery, Mission Hospital, Asheville, NC (T.R.K.); Division of Vascular and Endovascular Trauma Surgery, R Adams Cowley Shock Trauma Center, Baltimore, MD (R.K.); Department of Surgery, Methodist Dallas Medical Center, Dallas, TX (M.L.); Department of Surgery, Division of Vascular Surgery, New York University Langone Health, New York City, NY (G.A.M.); Department of Surgery, Division of Acute Care, Trauma & Burn Surgery, The Medical University of South Carolina, Charleston, SC (A.R.P.); Department of Surgery, Division of Acute Care and Regional General Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI (S.A.S.); General Surgery, Trauma & Surgical Critical Care, Department of Surgery, Yale, New Haven, CT (K.M.S.); Department of Surgery, Division of Acute Care Surgery, University of California San Francisco, San Francisco, CA (R.B.T.); Department of Trauma and Acute Care Surgery, Salem Health, Salem, OR (E.M.W.); Department of Surgery, Division of Acute Care Surgery, University of Kansas Medical Center, Kansas City, KS (J.L.H.); Department of Surgery, University of Maryland School of Medicine, Baltimore, MD (D.M.S.).

Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

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:
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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...
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following: