Tue, 20 May 2008|
In this fire EMS training video, Mike McEvoy shares tips on treating patients who may have sucking chest wounds.
Today I want to talk about injuries to the chest. In patients who have been assaulted. Often times people who have injuries than just such -- stab wounds from gunshots are not aware that they have those injuries. It might be marched right into you just learn that all the way through the trauma center. It's not an uncommon mistake to fail to expose -- -- test and to discover. What could be referred to as a sucking chest wound. In our patient here today. We're gonna talk a little bit about how. Wounds to the chest and treatment for injuries that potentially could be life threatening because the damage the integrity of the long itself. First step. And looking at any patient as the thoroughly exposed -- -- what we'll do with our patient here as -- -- this year. Look at the back. Of the patient. Make sure that the chest walls intact but there's no injuries to the back and posters surface and then look at the front of the chest. We noticed that there appears to be a wound to the side and -- Which could potentially be a sucking chest wound or something that is causing a -- one or acts in the patient. Signs and symptoms of that in patient could be difficulty breathing. Crap that -- or a rice crispy healing to the chest wall. Diminished breath sounds on that side of the test where -- injury occurs. Or there can be no symptoms -- a patient which is why many people are often unaware that -- have been shot or that. Any injury. That goes through the chest wall has to be considered. And opened just wrong and treated with an inclusive -- The conventional way that we plan to do that. Is to use -- cause such as zero form Glaus or vastly Glaus to seal the wound on the test. I'll demonstrate how that should be done and then I'll talk a little bit about. Patients who have multiple injuries in the chest wall or may not be practical -- in the time to -- Mostly because each one of the world. This patient. Well quite some body substance isolation precautions. Then we'll take the -- -- was crescent. Opened -- -- and we're gonna actually use the container of the dressing as part of inclusive. Package itself. It. Leave the dressing. On the foil wrapper. Move the fat part of it. And then -- the dressing. Over the wound itself. What we next need to do is to -- all three sides. Of the dressing. -- -- In all patients who apply and includes investing in the chest need to be sure it's addressing the larger. And the size of the wound on the chest let them. Dressing doesn't get sucked into the wound itself. Application. What we're doing now -- ceiling. Three side to -- the dressing with tape. The fourth side of the dressing. -- left open. So that we can relieve pressure the builds up inside the chest wall. There are two ways to do that. If the patient's conscious and breathing. And having increased difficulty agreement. You may ask the patient to cough and as they -- he would lift up. One side of the dressing and air would release from underneath addressing with the -- -- That the patient is not conscious. Or not able to -- you could use a bag valve mask. And give a breath -- the patient as you squeeze the bag. -- -- the dressing up and the patient would in effect have a cough that releases air from address. Next I wanna talk about a patient who has multiple injuries and the -- we may not have time to apply. Dressings to each one wounds. Whether you're an -- -- provider or -- provider. A piece of equipment that was useful to -- multiple wounds on the -- are decent deal efforts. They're round dressing they have an inclusive center to them. And are very convenient for multiple gunshot or multiple small stab wounds to the chest wall. If you have a patient with injuries like that you'd put an ECG electrodes. Over each one -- injuries he just world. You can do this very quickly. As very efficient. And it's an easy way to -- injuries. And occur all over the chest wall itself. One thing that you might want to do so that the hospital is not confused between an inclusive dressing and ECD electro. Is to label each one of the ECD electrodes. To indicate that there's a wound under -- sort of right on this one gunshot wound stab wound. Gunshot wound. That would give some indication that these are not easy to feel like -- but a close and dressings. -- -- Mac -- thanks for watching.