CHEST TRAUMA

1
CHEST TRAUMA

• SARAH FABIANO, MD

2
(No Transcript)
3
TODAYS LECTURE

• -DISCUSS BASIC MECHANISMS OF CHEST TRAUMA
• -DISCUSS CONCERNING CLINICAL FINDINGS OF CHEST
  TRAUMA
• -STERNOCLAVICULAR JOINT DISLOCATION
• -COMMOTIO CORDIS

4
CHEST TRAUMA In sports

• According to a study published in Athletic
  Therapy Today in 2004, life threatening chest
  trauma in contact sports is rare, however the
  athletic trainer and sports physical therapist
  need to evaluate this quickly.
• McGown AT. Blunt abdominal and chest trauma.
  Athletic Therapy Today. 20049(1)4041

5
CAUSES OF CHEST TRAUMA

• -COLLISION WITH ANOTHER PLAYER
• -RUN INTO A STATIONARY OBJECT
• -HIT BY AN OBJECT

6
TYPICAL S/S OF CHEST INJURY IN ATHLETES

• -DYSPNEA
• -SIGNS OF SHOCKTHREADY PULSE, DIAPHORETIC
• -FEELING OF IMPENDING DOOM
• -HEMOPTYSIS
• -DECREASED BREATH SOUNDS
• -IRREGULAR PULSE
• -TRACHEAL DEVIATION
• -DISTENDED NECK VEINS

7
Careful examination of the chest wall
8
But this looks pretty good
9
(No Transcript)
10
STERNOCLACVICULAR JOINT DISLOCATION

• CLAVICLE INJURIES ARE COMMON AND CAN INCLUDE
• -FRACTURE
• -AC JOINT SEPERATION
• -SHOUDLER SEPERATION
• A SC JOINT DICLOCATION IS SOMETHING NOT TO
  MISS.
• Commonly happens in a pile up during football.
• BEHIND THIS JOINT ARE VASCULAR AND AIRWAY
  STRUCTURES THAT CAN BE COMPROMISED

11
(No Transcript)
12
COMMOTIO CORDIS

• -WHEN AN ATHLETE IS STRUCK IN THE CHEST BY AN
  OBJECT, BUT HAPPENS TO FALL AT THE BEGINNING OF
  THE T-WAVE OF THE CARDIAC CYCLE

13
COMMOTIO CORDIS

• -ACCORDNG TO A STUDY BY MARON IN 1999, THE CASES
  THEY REVIEWED SHOWED THAT BASEBALL, SOFTBALL, AND
  ICE HOCKEY WERE THE MOST COMMON SPORTS.
• -7/70 SURVIVED THE INJURY, 11/70 HAPPENED DESPITE
  CHEST PADDING
• -THE KEY----AED----SHOCK, SHOCK, SHOCK
• https//www.youtube.com/watch?vLLtzT2bXVGI
• Maron, Clinical profile of Commotio Cordis An
  underappreciated cause of sudden death in the
  young during sports and other activities. Journal
  of Cardiovascular Electrophysiology. 1999.

14
KEY POINTS

• -REMEMBER TO EXAMINE THE CHEST COMPLETELY
• -REMEMBER THE CONCERNING SIGNS OF CHEST TRAUMA
  AND RE-EXAMINE THE ATHLETE
• -COMMOTIO CORDIS---KNOW WHERE AND HOW TO USE THE
  AED

15

• THANK YOU
• sfabiano_at_ghs.org