A nurse is assessing a client who has a tension pneumothorax following blunt chest trauma

Last UpdatedMarch 5, 2024

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placing a bulky dressing over the affected side of the chest. With a tension pneumothorax, the accumulation of air in the pleural cavity causes a mediastinal shift. Pneumothorax can happen with or without visible signs of injury to the chest. to insert antibiotics into the pleural space. So, if you are studying for NCLEX or your nursing lecture exams be sure to check out that section. Pneumothorax Diagnosis Questions and Answers. Correct answer: C. Which assessment should the nurse expect to identify?, While the nurse obtains a male client's history, review of systems, and physical examination, the client tells the nurse that his breast drains fluid secretions from the nipple. A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. A sucking sound at the site of injury, A male patient Treatment. Immediately replace the chest tube system 4. Pneumothorax can be caused by penetrating or blunt trauma; many patients also have a hemothorax (hemopneumothorax). to promote formation of lung scar tissue. , Why would it be inappropriate to Study with Quizlet and memorize flashcards containing terms like Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the:, A male patient has a sucking stab wound to the chest. A sucking sound at the site of injury, The nurse is caring Mar 1, 2024 · The focused assessment with sonography for trauma (FAST) exam is used primarily to assess for pericardial tamponade and hemoperitoneum, while the extended FAST (E-FAST) adds chest views to evaluate for pneumothorax (algorithm 2). D. hypovolemic shock Study with Quizlet and memorize flashcards containing terms like A client is admitted to the emergency department (ED) following blunt trauma to the chest from a motor vehicle accident. A patient presents with a heart rate of 105 beats per minute, a respiratory rate of 25 breaths per minute, and oxygen saturation of 90%. which of the following is true regarding the pathophysiology of pneumonia? pneumonia is caused by bacterial An emergency room nurse is assessing a client who has sustained a blunt injury to the chest wall. B. [ 6] The presentation depends on the mechanism of injury and the organ systems injured. Which sign, if noted in the client, would indicate the presence of a pneumothorax? A. Point-of-care ultrasound can also identify hemothorax, but this is not a routine part of the E-FAST exam. Collapsed neck veins on the unaffected side c. Tension pneumothorax. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. In the previous review, I covered other respiratory disorders. no evidence of tidaling. The nurse interprets this finding as which of the ff?, 43. 2 2) Correct - tension pneumothorax is an extremely serious emergency, even more than an open pneumothorax; motor vehicle accidents and blunt chest trauma are two potential causes; tension pneumothorax results from air moving into the pleural space and not being able to move back out; pressure builds up in the chest and if it is untreated, the heart, trachea, esophagus, and great vessels are May 25, 2023 · A nurse is assessing a client who has a tension pneumothorax following blunt chest trauma. Two major forms of traumatic injury to the chest are blunt and penetrating injuries. In a recumbent, immobilized patient, lung ventilation may become altered, leading to the respiratory complications such as: A. This can lead to air being pulled or sucked inward and collapsing the lung. The presence of a barrel chest d. surgically removing the portion of the lung that is damaged. A low respiratory 2. Unequal lung expansion and dyspnea would indicate a pneumothorax. Rib and sternal fractures can lacerate lung tissue. TEST-TAKING HINT: The test taker can use "chest trauma" or "pneumothorax" to help select the correct answer. The chest wound is located on the left mid-axillary area of the chest. The majority of emergency medical service (EMS) providers in the United 12. large amount of bloody drainage in the drainage collection chamber. the chest wall has a communicating pneu-mothorax. frothy, pink-tinged sputum. A tension pneumothorax is a severe . Jul 24, 2023 · Traumatic pneumothorax is the second most common injury in chest trauma, accounting for 50,000 cases a year in the United States. Insertion site dressing is occlusive. ) the presence of a barrel chest D. Chest injuries account for nearly one-fourth of all trauma-related mortality, second only to head and neck injuries. Organs. 114 It is a serious condition, because it may eventually develop into tension pneumothorax. A sucking sound at the site of injury, The low The nurse is assessing a client who had a chest tube inserted for a chylothorax three hours ago. The nurse B. On assessment, you note there is unequal rise and fall of the chest with absent breath sounds on the left side. Tracheal deviation to the affected side d. The nurse is providing morning care to a client who has a closed chest tube drainage system to treat a pneumothorax. A low respiratory rate B. Which of these signs would indicate the presence of a pneumothorax in this client? 1. 4. A sucking sound at the site of injury 1. Supine position with the head of the bed elevated to 15degrees. Develop skills in conducting a focused assessment to promptly identify and prioritize interventions. Spontaneous pneumothorax, What will be the immediate nursing action if the nurse, while caring for a patient with chest trauma, finds that the drainage system in the patient is broken? 1. Both of these words should cause the test taker to select "2" because unequal chest expansion would result from trauma. MVCs account for 70% to 80% of blunt chest injuries. The most common symptoms of this condition are acute, unilateral chest pain and shortness of breath. What signs and symptoms would the nurse anticipate recording to support this diagnosis? Select All That Apply 1. 25 Pneumothorax and Hemothorax. List what the impact can cause to: Lungs. Respiratory alkalosis D. (See also Overview of Thoracic Trauma . Flat neck veins C. a nurse is caring for a client with pneumonia. Some vascular injuries can be managed conservatively. A low respiratory rate 2. Ans: 2. They often require rapid intervention and stabilization, whether they are from penetrating (ie, gunshots, lacerations, punctures) or blunt (ie, motor vehicle accidents, falls, crush Recognize and interpret the signs and symptoms associated with blunt chest trauma, such as chest pain, difficulty breathing, altered breath sounds, and potential life-threatening complications. c. A nurse is assessing a client who has tension pneumothorax. Hypertension B. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?, You are caring for a client status post lung resection. A chest X-ray is immediately ordered by the physician. Tracheal deviation to the right, The nurse Apr 17, 2023 · Chest trauma has quickly risen to be the second most common traumatic injury in non-intentional trauma. Which of the following findings indicates to the nurse the client is possible experiencing a tension pneumothorax? a. What action by the nurse takes priority? a. 109,110 OPTX occurs in 2%-20% of patients with blunt trauma. Prompt medical attention is crucial due to potentially life-threatening complications like pneumothorax or cardiac tamponade. The presence of a barrel chest, Paradoxical chest movement with a flail chest results in PICK ONE: Flail chest. What should the nurse suspect is occurring in this patient? 1. Point-of-care US (PoCUS) in the ED has been used as a means of detecting rib fractures in patients who have sustained blunt chest trauma, as well as for detecting pneumothorax. b. Quick thinking and early interventions are key factors for Mar 4, 2024 · Emergency medical services (EMS) providers commonly encounter patients with chest injuries. Chest pain in pneumothorax is described as a sudden, severe, stabbing pain that radiates to the shoulders and worsens with inspiration. There are no obvious signs of external bleeding, but the patient is hypovolemic and there are decreased breath sounds on the left side. Which of the following conditions should the nurse identify as being a complication of OSA? (Select all that apply. Nonalcoholic fatty liver disease, A nurse is caring for a client with Study with Quizlet and memorize flashcards containing terms like The client is admitted to the emergency department with chest trauma. minute volume will decrease. increased breath sounds on the affected side. 1. compensatory shock 4. Details pertaining to the initial assessment and management of a patient with blunt thoracic trauma are discussed below. The nurse is caring for a pt on mechanical ventilation with positive end expiratory pressure (PEEDP). The client had a right-sided chest tube inserted two (2) hours ago for a pneumothorax. 15 hours ago · a nurse is caring for a client who has OSA. Vessels. Study with Quizlet and memorize flashcards containing terms like During your rapid trauma examination of a patient with a chest injury, you would assess for air trapped under the skin in the upper chest and neck. The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Pain with respiration D. This is a type of pneumothorax wherein the chest wall breach occurred as a result of an injury from an invasive diagnostic procedure or therapy such as thoracocentesis or lung biopsy; or more commonly, a mechanical ventilator related injury. During your primary assessment of a patient with chest trauma, you determine that he may have a tension pneumothorax. High fowler's with arms supported on the overbed table. Primary survey — Initial resuscitation and management of the trauma patient is based upon principles from Advanced Trauma Life Support (ATLS) and is reviewed separately. A nurse is assessing a client who has experienced a gun shot wound. call for ALS backup. a nurse is assessing a client who has a tension pneumothorax following blunt chest trauma. Obtaining as detailed a clinical history as possible is extremely important in the assessment of a patient who has sustained Apr 17, 2023 · Chest trauma has quickly risen to be the second most common traumatic injury in non-intentional trauma. C. Hypertension E. There is an air leak somewhere in the system. The healthcare provider (HCP) has inserted a chest tube in a client with a pneumothorax. tracheal deviation to the unaffected side. Bronchovesicular lung sounds and bradypnea. Which intervention should the nurse include when planning this client's care?, A victim has sustained a blunt force trauma to the chest. Lateral position. Conduct a comprehensive pain assessment. Image. Absent breath sounds on affected side; Cyanosis; Decreased chest expansion unilaterally; Dyspnea Study with Quizlet and memorize flashcards containing terms like An emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. To our knowledge, emergency chest drainage following blunt chest trauma in patients with voluminous breast implants is not reported in the literature. In patients with difficulty breathing, severe injuries to consider during the primary survey include the following: Tension pneumothorax. to remove air and fluid. What should the nurse expect when assessing the drainage system? 1. The pneumothorax is resolving. Diminished breath sounds 3. A. Diminished breath sounds c. The most common causes of mortality in trauma victims include hemorrhage, cardiopulmonary arrest, and Study with Quizlet and memorize flashcards containing terms like The emergency room nurse is assessing a client who has sustained a blunt injury to the chest wall. The nurse observes periodic air bubbles in a pt's chest tube water seal chamber. Chest tube is secured with tape to the client's skin below the dressing. A hemothorax and pneumothorax are suspected. A primary pneumothorax occurs in a patient without a known respiratory disease, whereas a secondary pneumothorax occurs in a patient with pre-existing respiratory disease. The suction chamber system is shut off. A sucking sound at the site of injury, The nurse is caring Call the health care provider 2. Massive hemothorax can result from either blunt or penetrating trauma. Decreased heart rate 3 The case study highlights several complications that commonly develop in trauma patients who sustain blunt chest injuries with underlying lung injury and discusses essential nursing assessment and care. The clinical results are dependent on the degree of collapse of the lung on the affected side. Which of these signs would indicate the presence of a pneumothorax? a. This quiz offers a detailed exploration of the Read more. Semi-fowler's position with pillows supporting both arms. Nov 10, 2022 · No patient in this group developed a tension pneumothorax or experienced adverse events by delaying tube thoracostomy. A physical exam will also demonstrate specific clinical signs, such as tracheal deviation away from the affected side, decreased or absent breath sounds on the affected side, and subcutaneous emphysema on the affected side. Traumatic pneumothorax d. Apr 20, 2024 · Chest trauma is the second most frequently occurring unintentional traumatic injury and the third most common cause of death after abdominal injury and head trauma in patients with polytrauma. for administration of oxygen. In a high-velocity impact the shearing force ma result in laceration or tearing of the aorta. On assessment, the chest is intact and auscultation reveals decreased A nurse working in the ED is caring for a pt following an acute chest trauma. [2] While penetrating chest trauma is less common than blunt trauma, it can be more deadly. which pf the following physiological factors is true in a client with OSA? muscle tone of the nasopharynx is reduced, which contracts the airway. Open pneumothorax. A sucking sound at the site of injury, A nurse is caring for a Study with Quizlet and memorize flashcards containing terms like A client is brought to the emergency department following a motor vehicle accident. Pneumothorax NCLEX Question Quiz. jugular vein distention. periodic bubbling in the water seal chamber immediately after insertion. 6 (101. call medical command for permission to decompress the chest. Tension pneumothorax b. Quick thinking and early interventions are key factors for Study with Quizlet and memorize flashcards containing terms like A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. 4 Sep 30, 2022 · The routine use of high-resolution CT imaging after trauma has improved the detection of lower-grade blunt aortic injuries, such as intimal tears and flaps. Shortness of breath2. When assess- ing the client, which signs/symptoms would the nurse expect to find that support the diagnosis of pneumothorax? 1. S. When assessing the pt which of the ff would indicate the possibility of tension pneumothorax? and more. 4), and SaO2 95% on oxygen 15L/min via non-rebreather mask. tension pneumothorax. Complete the following sentence by using the lists of options. Jan 22, 2017 · Pneumothorax is defined as the presence of air or gas in the pleural cavity (ie, the potential space between the visceral and parietal pleura of the lung), which can impair oxygenation and/or ventilation. ) a sucking sound at the site of injury, The nurse is caring Study with Quizlet and memorize flashcards containing terms like A nurse is caring for a client who has obstructive sleep apnea (OSA). Which of the following indicates that the pneumothorax is worsening? A. hemorrhage 3. A patient is admitted with a chest wound and experiencing extreme dyspnea, tachycardia, and hypoxia. subcutaneous emphysema. Shortness of breath C. Blunt trauma commonly results in chest-wall injuries (eg, rib fractures). A low respiratory rate D. d. Written consent was provided by the patient for this case Oct 28, 2021 · A pneumothorax is a collection of air inside the pleural space, which is the space between the lungs and chest wall (Figure 1). The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Unequal lung expansion and dyspnea. The drainage chamber is full. Altered cognition C. ) diminished breath sounds C. During the last hour, 90 ml of serosanguinous fluid was removed into a drainage collection chamber, fluctuation of water appears in the water seal chamber when the client breathes in and out, and bubbling in the suction control chamber has been continuous. 2. pleural friction rub. The investigators concluded that whereas most blunt trauma patients with OPTX can be carefully monitored without tube thoracostomy, OPTX progression and respiratory distress were significant predictors of failed observation. What should she be particularly alert for? Study with Quizlet and memorize flashcards containing terms like An emergency room nurse is caring for a client who sustained a blunt injury to the chest wall. Following these injuries, patients may present with a simple dyspnea Nursing questions and answers. A pulmonary contusion is suspected. The most critical treatment for a tension pneumothorax involves: A. ) a sucking sound at the site of injury, The nurse is caring May 23, 2023 · Tension pneumothorax is the presumed diagnosis when patients present with chest trauma, respiratory distress, and hypotension. Iatrogenic pneumothorax c. which of the following findings should the nurse expect? a. tracheal deviation. vigorous bubbling in the suction control chamber. Spontaneous pneumothorax. Chest trauma results in the highest mortality, reaching up to 60% in some studies. assisting the patient's breathing with increased tidal volume. In patients with severe trauma, 25% of deaths are due to chest trauma. ) Tension pneumothorax develops when a lung or chest wall injury is such that it allows air into the pleural space but not out of it (a one-way valve). Study with Quizlet and memorize flashcards containing terms like A victim has sustained a blunt force trauma to the chest. Bradypnea B. The presence of a barrel chest D. Frothy bloody sputum and consolidation. 1 A tension pneumothorax may be caused by pene-trating or blunt trauma, barotrauma resulting from positive pressure Jul 24, 2023 · Traumatic pneumothorax is the second most common injury in chest trauma, accounting for 50,000 cases a year in the United States. Study with Quizlet and memorize flashcards containing terms like 24. To identify potential complications like pneumothorax, Nurse Lisa needs to know which sign is most indicative. The client reports dyspnea and pain. In the United States, trauma is the leading cause of death in young adults and accounts for ten percent of death in all men and women. Which of the following clinical manifestations correlate with a moderate pulmonary This is an NCLEX review for pneumothorax . Tension pneumothorax 2. tension pneumothorax 2. Rationale: Blunt chest trauma can cause an air leak into the thoracic cavity, collapsing the lung on the side with the air leak. A nurse working in an emergency department is caring for a client following an acute chest trauma. In the U. Rib fractures are one of the most common injuries sustained from blunt chest trauma and frequently co-exist with underlying lung injury. Jan 30, 2024 · Go to: Pneumothorax is a potentially life-threatening condition, a principal diagnosis that emergency medical services (EMS) providers must promptly identify. Which type of pneumothorax should the nurse suspect is occurring? a. Nov 10, 2022 · Pathophysiology. Chapter 30, Page 1095. Which of the following findings should the nurse expect following tracheal deviation? A. Massive hemothorax is defined by the need for thoracotomy — the indications are: Blood loss > 1,500 mL or 1/3rd of blood volume. Patients who have a pneumothorax are experiencing a collapse lung due to air leaking into the intrapleural space. 1,2 Other possible causes of blunt chest injury include acts of violence, falls, and blast injuries. The nurse suspects that the patient has which of these conditions? 1. Study with Quizlet and memorize flashcards containing terms like Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the:, A male patient has a sucking stab wound to the chest. Tracheal 127. Diminished breath sounds C. Which of the following should you suspect? 1-Pneumothorax 2-Hemopneumothorax 3-Traumatic asphyxia 4-Hemothorax Apr 25, 2024 · Also, you can share the quiz with others who want to learn about pneumothorax. Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial injuries. ) a low respiratory rate B. Study with Quizlet and memorize flashcards containing terms like The client is admitted to the emergency department with chest trauma. Notify the Rapid Response Team. Cystic fibrosis B. More air enters the pleural space with each breath, increasing intrathoracic pressure on the affected side, moving the trachea to the unaffected side, and leading to decreased cardiac output. Tension pneumothorax is accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart. In order to treat this condition, you should: Question content area bottom Part 1 A. 3. Sepsis due to leakage of alimentary tract contents, as in esophageal perforations, also must be considered. Which action should the nurse take first?, Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in • Simple pneumothorax can become tension pneumothorax when positive pressure ventilation applied Module 5: Pediatric Blunt Abdominal and Chest Trauma Pediatric Trauma Biomechanics Nov 10, 2022 · The clinical presentation of patients with blunt chest trauma varies widely and ranges from minor reports of pain to florid shock. If the pneumothorax is significant, it can Study with Quizlet and memorize flashcards containing terms like An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Blunt trauma. 111,112,113 In addition, OPTX develops in 51% of trauma patients with pneumothorax. insert a chest tube using items from the OB kit. Findings include BP 108/55, HR 124/min, RR 36/min, temperature 38. 4 Apr 27, 2018 · Blunt trauma occurs when the chest strikes or is struck by an object. The nurse is caring for David (pronouns: he, him, his), a client recovering from a pneumothorax with a chest tube in place. ) A. Diminished breathe sounds 3. A patient has a chest tube inserted for a pneumothorax. Shortness of breath 2. A nurse working in the ED is caring for a pt following an acute chest trauma. Which of these signs would indicate the presence of a pneumothorax in this client? A. A low respiratory rate b. Study with Quizlet and memorize flashcards containing terms like A client is admitted to the emergency department (ED) following blunt trauma to the chest from a motor vehicle accident. Study with Quizlet and memorize flashcards containing terms like A client is admitted to the Emergency Department with a tension pneumothorax. [22, 23] A patient is admitted to the hospital with injuries from a motor vehicle crash. You are assessing a patient who sustained a blunt force chest injury during a motorcycle accident. Which finding indicates the presence of a pneumothorax in this client? A. Which of the following nursing assessment is significant in diagnosing this client with flail chest? a) Clubbing of fingers and toes b) Respiratory acidosis c) Paradoxical chest movement d) Chest pain on inspiration, You are caring for a client Study with Quizlet and memorize flashcards containing terms like A client hospitalized with pneumonia has thick, tenacious secretions. Dilated ventricles C. Decreased heart rate3 May 23, 2023 · Trauma is the leading cause of death worldwide. 1 Motor vehicle crash (MVC) injuries are a significant cause of blunt chest injury. The source of bleeding can be from the lungs, major vessels, intercostal vessels or even the heart. Oct 28, 2022 · Assessment: 1. 86. Which finding indicates the presence of a pneumothorax in this client? a. Study with Quizlet and memorize flashcards containing terms like A nurse is assisting in planning care for a client who has flail chest. Assess the clients lung sounds. Flail chest. , there are approximately 50 million visits to the emergency department annually related to trauma. Chest. Many of these injuries are stable, and repair can proceed in a planned fashion within a few days. (See also Overview of Thoracic Trauma. Provide reassurance to the client. If it is present, this condition is called: A. During the nurse's initial assessment, the patient develops hypotension and severe jugular distention with a tracheal deviation. The majority of emergency medical service (EMS) providers in the United Study with Quizlet and memorize flashcards containing terms like A hospitalized client is dyspneic and has been diagnosed with a left tension pneumothorax by chest x-ray after insertion of a central venous catheter. Jan 29, 2019 · Pneumothorax is one of the most poorly understood and least frequently reported complications associated with breast augmentation ( 2 ). Assessment. When assessing your client you find that the bubbling in the water-seal chamber for Intravenous fluid resuscitation should be limited, as further distention of an already dilated right ventricle can worsen hemodynamics. [1] Trauma to the chest is also associated with the highest mortality; in some studies, up to 60% depending on the mechanism of injury. Rib fractures alone are associated with high morbidity TEST-TAKING HINT: The test taker can use "chest trauma" or "pneumothorax" to help select the correct answer. Which action should the nurse take first?, Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in Apr 28, 2024 · Chest trauma involves injury to the thoracic cavity, affecting structures like the lungs, heart, ribs, and major blood vessels. Bone structure. Place a sterile dressing over the disconnection site, The nurse is assessing the functioning of a chest tube drainage system in a client who has just returned from the recovery room following a thoracotomy with wedge Mar 1, 2024 · Algorithm 2. Spontaneous Apr 30, 2023 · Iatrogenic Pneumothorax. Blunt chest trauma and penetrating chest trauma are the primary causes of traumatic and tension pneumothorax. Iatrogenic pneumothorax 3. Massive hemothorax. The presence of a barrel chest 4. Which finding would indicate the presence of a pneumothorax in this client? 1. Additionally, the patient complains of chest pain. Increased venous return B. Nurse Lisa is in the emergency room, caring for Karen, a 30-year-old woman who has suffered a blunt injury to her chest wall following a car accident. Which normal assessment findings should the nurse anticipate? Select all that apply. Treatment. The nurse notices respiratory distress and no breath sounds over the left chest. The nurse should evaluate the effectiveness of the cheset tube: 1. 115 Therefore, OPTX should be kept in mind in patients May 25, 2023 · A nurse is assessing a client who has a tension pneumothorax following blunt chest trauma. Traumatic pneumothorax 4. Collapsed neck veins on the affected side b. A male patient has chronic obstructive pulmonary disease (COPD) and is a smoker. Take a full set Nov 10, 2022 · The sensitivity, specificity, and overall accuracy of US in these settings are all greater than 90%. Apr 20, 2020 · As a result of chest trauma, many injuries may occur, such as pulmonary injuries, and these require urgent intervention. Place the tube in a bottle of sterile water 3. It can result from blunt or penetrating mechanisms, such as car accidents or stabbings. Decreased cardiac output ATI Med Surge Ch. Study with Quizlet and memorize flashcards containing terms like The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. |. Types of Pneumothorax according to pathophysiology. In patients with penetrating wounds that traverse the mediastinum (eg, wounds medial to the nipples or to the scapulae), or with severe blunt trauma, pneumothorax may be caused by disruption of the tracheobronchial tree. Other possible causes include therapeutic procedures such as thoracotomy, thoracentesis, and insertion of a central line. Pneumothorax can affect all age groups. A sucking sound at the site of injury Apr 20, 2020 · CXR cannot diagnose more than half of pneumothorax cases. Pneumothorax management relies on early recognition and treatment by prehospital providers to prevent the development of respiratory failure or obstructive shock from “tension” physiology. Headaches D. There is a simplified, rapid approach to help differentiate these injuries (see figure A Simplified, apid Approach to Assessment of Patients With Chest Trauma). yl ny re fw od sf by mc qz gf