Trauma Series: Chest Trauma

by: Scott P. Whetsell

MFRI Field Instructor Trauma Series: Chest Trauma LESSON PLAN

TOPIC Chest Trauma

TIME FRAME 3 hours

LEVEL OF INSTRUCTION Cognitive (1.5 hours), Psychomotor (1.5 hours)

LEARNING OBJECTIVES - Following the lecture, the student will have a greater understanding of the management of thoracic injuries in the trauma patient. - Following demonstration, the student will be able to assess, identify, and treat a variety of thoracic injuries.

RESOURCES / PowerPoint Presentation MATERIALS NEEDED Trauma supplies for addressing thoracic injuries

PRE-REQUISTIES None

REFERENCES Brady Emergency Care, Thirteenth Edition Medscape MIEMSS National Institute of Health Trauma.org Wikipedia

LESSON SUMMARY This lesson is designed to review thoracic injuries and treatment.

ASSIGNMENTS None.

LESSON OUTLINE

INTRODUCTION a. Instructor Name b. We are going to discusschest trauma. MOTIVATOR Thoracic injuries pose a significant threat to survivability of our patients. Being able to identify, triage, and treat thoracic injuries can help decrease morbidity and mortality in these patients. STUDENT PERFORMANCE OBJECTIVES 1. Following the lecture, the student will have a greater understanding of the management of thoracic injuries in the trauma patient. 2. Following demonstration, the student will be able to assess, identify, and treat a variety of thoracic injuries. OVERVIEW In order to meet these objectives, we will: - discuss anatomy and physiology pertaining to the chest. - discuss assessment of the trauma patient. - discuss various thoracic injuries. - divide into groups of three to five members and practice the following practical skills: . Trauma Assessment (rapid and focused)  Include both life threatening and non-life threatening injuries . Commotio cordis . Flail chest . Sucking chest wound . Pericardiocentesis (cardiac tamponade) . Needle thoracostomy (pneumothorax / tension pneumothorax) THORACIC INJURIES I. Introduction / Background II. Anatomy Review a. Thorax definition b. Thoracic portion of the axial skeleton c. Significant internal organs / structures

III. Patient Assessment a. Scene size-up i. BSI ii. Scene safety iii. Mechanism of injury iv. Number of patients v. Additional resources vi. Consider C-spine b. Primary assessment i. General impression ii. Check responsiveness iii. ABC / CAB I. Airway II. Breathing III. Circulation iv. Disability v. Exposure vi. Patient priority / transport decision c. Secondary Assessment i. Rapid or focused assessment ii. DCAP-BTLS iii. Physical examination methods iv. Treatment of injuries v. Obtain vital signs vi. Treatment for shock d. Transport i. Initiate transport ii. Reassessment IV. Injuries a. Mechanisms of injury i. Penetrating ii. Blunt

b. Specific injuries i. Pneumothorax ii. Tension pneumothorax iii. Hemothorax iv. Hemopneumothorax v. Flail chest vi. Cardiac tamponade vii. Commotio cordis viii. Traumatic asphyxia ix. Aortic injury and dissection x. Diaphragm injuries V. Skills Practice a. Demonstrate the trauma assessment and treatment procedures. b. Divide into groups of three to six. c. Groups should practice the trauma assessment and treatment procedures. i. Ensure all team members get a chance to practice. ii. Instructor should provide feedback and guidance. CONCLUSION I. Summary II. Review Student Performance Objectives: 1. Following the lecture, the student will have a greater understanding of the management of thoracic injuries in the trauma patient. 2. Following demonstration, the student will be able to assess, identify, and treat a variety of thoracic injuries.

EVALUATIONS Students shall correctly perform the skills in a timely manner without input from an instructor. An in-class practicalquiz may be administered at the discretion of the instructor. Emphasis should be placed on observed areas of weaknesses in the knowledge base of the target audience.