Nursing 322: Fall 2007

Chest Trauma Roundtable

You have no more than 5-10 minutes on your selected content.  In this time you need to address the questions in your particular role/content area and be aware of the class outcomes.  The reading assignments and questions are listed below.  If you have difficulty accessing articles or are unclear on what to do, please contact me.  Be aware that the answers come from multiple places including your textbook and that it will be insufficient to look at only one source.

As a presenter, you are welcome to have a SHORT handout (no more than the front side of an 8X11 sheet of paper).  DO NOT READ OFF OF THE HANDOUT.  Present in the way you would want to be presented to. 

Everyone should view the accident and read the scenario located here:

For the ER/ETU Nurse Group

 1. Review the “Chest Trauma Initial Evaluation” from the following page:  www.trauma.org 

                                                                                (use the loginname: mbyrne password: u24444)

        ·         What are the priorities of care?

·         List key assessments and assessment findings when doing a look, listen, feel, percuss assessment

·         Discuss the difference between a primary and a secondary survey in terms of what you might find or need to treat

·         What medications, IV fluids and diet would be expected in a patient who has come in with chest trauma?

·         How would you get in touch with the patient's family and what would you tell them?

For the pulmonary contusion, rib fracture*, flail chest and pneumothorax# Groups

Review your textbook, the www.trauma.org website (use login name mbyrne password u24444) and the two articles listed below (both are available full-text online):

1. List what might cause these injuries
2. Discuss the anatomical/physiological changes
3. Describe what you would find in your physical assessment
4. List emergency and supportive care
5. List nursing considerations for the injury

 (*Rib fracture group: focus heavily on nursing considerations, #Pneumothorax group: differentiate between open, closed, tension and hemopneumothorax)

Keough, V., & Pudelek, B. (2001). Blunt chest trauma: Review of selected pulmonary injuries focusing on pulmonary contusion. AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 12(2), 270-281.

Yeo, T. P. (2001). Long-term sequelae following blunt thoracic trauma. Orthopaedic Nursing, 20(5), 35-47.

Labs/Diagnostics Group

• Discuss what lab tests and diagnostics might be appropriate for pulmonary contusion, rib fracture, flail chest and pneumothorax.  Are there are

• What do nurses need to know, need to do and what do they need to tell the patient about these tests?

 Review the information found at www.trauma.org (login mbyrne, password u24444) related to diagnostics, carefully review your text  (reading assignment and Table 25-11 on pps. 560-561) and think critically about the above questions…not all of the answers will be in your text or on the web page.

Discharge/Case Coordination & Rehabilitation

Review your text book and the article below (available full text online)

• What are some long term physical and psychological problems that might be an issue for this patient?
• Carefully review the article below and consider what you might need to help this patient do or have set up before discharge or specific discharge teaching that might need to occur.

Yeo, T. P. (2001). Long-term sequelae following blunt thoracic trauma. Orthopaedic Nursing, 20(5), 35-47.