Blunt chest trauma: a clinical chameleon

Heart ◽  
2017 ◽  
Vol 104 (9) ◽  
pp. 719-724 ◽  
Author(s):  
Kaveh Eghbalzadeh ◽  
Anton Sabashnikov ◽  
Mohamed Zeriouh ◽  
Yeong-Hoon Choi ◽  
Alexander C Bunck ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Blunt Chest Trauma ◽  
High Speed ◽  
Chest Trauma ◽  
Motor Vehicle ◽  
Cardiac Injury ◽  
Jugular Veins ◽  
Early Management ◽  
Vehicle Accidents ◽  
Appropriate Therapy

The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury. However, on admission to emergency departments symptoms might be missing or may not be clearly associated with the injury. Accurate diagnostics and early management in order to prevent serious complications and death are essential for patients suffering a BCT. Optimal initial diagnostics includes echocardiography or CT, Holter-monitor recordings, serial 12-lead electrocardiography and measurements of cardiac enzymes. Immediate diagnostics leading to the appropriate therapy is essential for saving a patient’s life. The key aspect of the entire management, including diagnostics and treatment of patients with BCT, remains an interdisciplinary team involving cardiologists, cardiothoracic surgeons, imaging radiologists and trauma specialists working in tandem.

Pneumopericardium in blunt chest trauma after high-speed motor vehicle accidents

2005 ◽  
Vol 23 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Roland Ladurner ◽  
Lars M. Qvick ◽  
Felix Hohenbleicher ◽  
Klaus K. Hallfeldt ◽  
Wolf Mutschler ◽  
...  
Keyword(s):  
Blunt Chest Trauma ◽  
High Speed ◽  
Chest Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents

scholarly journals Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Daniel H. Wolbrom ◽  
Aleef Rahman ◽  
Cory M. Tschabrunn
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Motor Vehicle ◽  
Structural Heart Disease ◽  
Chest Injury ◽  
Chronic Stage ◽  
Chest Wall Injury

Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can be the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor vehicle accidents or traumatic falls. In this setting, the manifestation of ventricular arrhythmias has been observed both acutely and chronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation can occur immediately after chest wall injury (commotio cordis) and requires rapid defibrillation. Monomorphic ventricular tachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury. The associated arrhythmogenic tissue may be complex and provides the necessary substrate to form a reentrant VT circuit. Ventricular tachycardia in the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of the VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest injury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and treatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma.

Circumferential fracture of the skull base causing craniocervical dislocation

2002 ◽  
Vol 97 (1) ◽  
pp. 118-122 ◽  
Author(s):  
Ganesh Rao ◽  
Adam S. Arthur ◽  
Ronald I. Apfelbaum
Keyword(s):  
High Speed ◽  
Unusual Case ◽  
Motor Vehicle ◽  
Neurological Impairment ◽  
Craniocervical Junction ◽  
Motor Vehicle Accidents ◽  
Review Of The Literature ◽  
Content Type ◽  
Vehicle Accidents ◽  
Fine Print

✓ Fractures of the craniocervical junction are common in victims of high-speed motor vehicle accidents; indeed, injury to this area is often fatal. The authors present the unusual case of a young woman who sustained a circumferential fracture of the craniocervical junction. Despite significant trauma to this area, she suffered remarkably minor neurological impairment and made an excellent recovery. Her injuries, treatment, and outcome, as well as a review of the literature with regard to injuries at the craniocervical junction, are discussed.

Perils of Rib Fractures

2008 ◽  
Vol 74 (4) ◽  
pp. 310-314 ◽  
Author(s):  
Om P. Sharma ◽  
Michael F. Oswanski ◽  
Shashank Jolly ◽  
Sherry K. Lauer ◽  
Rhonda Dressel ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Close Observation ◽  
Motorcycle Crashes ◽  
Level 1 Trauma Center

Rib fractures (RF) are noted in 4 to 12 per cent of trauma admissions. To define RF risks at a Level 1 trauma center, investigators conducted a 10-year (1995–2004) retrospective analysis of all trauma patients. Blunt chest trauma was seen in 13 per cent (1,475/11,533) of patients and RF in 808 patients (55% blunt chest trauma, 7% blunt trauma). RF were observed in 26 per cent of children (<18 years), 56 per cent of adults (18–64 years), and 65 per cent of elderly patients (≥65 years). RF were caused by motorcycle crashes (16%, 57/347), motor vehicle crashes (12%, 411/3493), pedestrian-auto collisions (8%, 31/404), and falls (5%, 227/5018). Mortality was 12 per cent (97/808; children 17%, 8/46; adults 9%, 46/522; elderly 18%, 43/240) and was linearly associated with a higher number of RF (5% 1–2 RF, 15% 3–5 RF, 34% ≥6 RF). Elderly patients had the highest mortality in each RF category. Patients with an injury severity score ≥15 had 20 per cent mortality versus 2.7 per cent with ISS <15 ( P < 0.0001). Increasing age and number of RF were inversely related to the percentage of patients discharged home. ISS, age, number of RF, and injury mechanism determine patients’ course and outcome. Patients with associated injuries, extremes of age, and ≥3 RF should be admitted for close observation.

scholarly journals Profile of care given to patients with blunt chest injuries within the first 48 hours

Curationis ◽  
2000 ◽  
Vol 23 (2) ◽  
Author(s):  
E Nyangena
Keyword(s):  
Chest Trauma ◽  
Motor Vehicle ◽  
Psychosocial Care ◽  
Initial Assessment ◽  
Academic Hospital ◽  
Vehicle Accidents ◽  
Chest Injuries ◽  
Analyse Data ◽  
Record Review ◽  
Descriptive Survey

This study was conducted in the trauma unit of a large academic hospital in Johannesburg, South Africa. The study aimed at describing the nature of care that patients with blunt chest injuries received during the first 48 hours after injury. A descriptive survey was chosen using retrospective and prospective record review to obtain data. The sample comprised 60 records of patients who were admitted to the hospital due to blunt chest injuries between January 1997 and June 1998. Descriptive statistics were used to present and analyse data. The study showed that: (i) Blunt chest trauma victims received a thorough initial assessment and care. No missed injuries were identified on subsequent assessment; (ii) More than half of the patients spent over one hour in the accident/emergency department before admission to the trauma ward or intensive care unit (ICU); (iii) Motor vehicle accidents (MVA) were the commonest cause of injury while pedestrian vehicle accidents (PVA) were often fatal; (iv) Nurses are good providers of care but poor in prescribing and documenting care; (v) Pain assessment and psychosocial care was often neglected; (vi) Less than half the patients developed complications during the first 48 hours; pain and pneumonia being the most common complications encountered.

Isolated Right Atrial Rupture From Blunt Chest Trauma in Motor Vehicle Collisions

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alessandro Feola ◽  
Valerio Mastroianni ◽  
Irene Adelaide Scamardella ◽  
Pierluca Zangani ◽  
Bruno Della Pietra ◽  
...  
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Motor Vehicle ◽  
Right Atrial ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Atrial Rupture

A Numerical Analysis of Pre-Deployment Effect of Side-Impact Airbags in Reducing Occupant Injuries

2013 ◽  
Author(s):  
Yi Yang Tay ◽  
Rasoul Moradi ◽  
Hamid M. Lankarani
Keyword(s):  
Numerical Analysis ◽  
High Speed ◽  
Motor Vehicle ◽  
Side Impact ◽  
Element Analysis ◽  
Vehicle Accidents ◽  
Injury Criteria ◽  
Acceleration Sensors ◽  
Head Injury Criteria ◽  
Occupant Injuries

Side impact collisions represent the second greatest cause of fatality in motor vehicle accidents. Side-impact airbags (SABs), though not mandated by NHTSA, have been installed in recent model year vehicle due to its effectiveness in reducing passengers’ injuries and fatality rates. However, the increase in number of frontal and side airbags installed in modern vehicles has concomitantly led to the rise of airbag related injuries. A typical side-impact mechanical or electronic sensor require much higher sensitivity due to the limited crush zones making SABs deployment more lethal to out-of-position passengers and children. Appropriate pre-crash sensing needs to be utilized in order to properly restraint passengers and reduce passengers’ injuries in a vehicle collision. A typical passenger vehicle utilizes sensors to activate airbag deployment when certain crush displacement, velocity and or acceleration threshold are met. In this study, it is assumed that an ideal pre-crash sensing system such as a combination of proximity and velocity and acceleration sensors is used to govern the SAB pre-deployment algorithm. The main focus of this paper is to provide a numerical analysis of the benefit of pre-deploying SAB in lateral crashes in reducing occupant injuries. The effectiveness of SABs at low and high speed side-impact collisions are examined using numerical Anthropomorphic Test Dummy (ATD) model. Finite Element Analysis (FEA) is primarily used to evaluate this concept. Velocities ranging from 33.5mph to 50mph are used in the FEA simulations. The ATD used in this test is the ES-2re 50th percentile side-impact dummy (SID). Crucial injury criteria such as Head Injury Criteria (HIC), Thoracic Trauma Index (TTI), and thorax deflection are computed for the ATD and compared against those from a typical airbag system without pre-crash sensing. It is shown that the pre-deployment of SABs has the potential of reducing airbag parameters such as deployment velocity and rise rate that will directly contribute to reducing airbag related injuries.

scholarly journals Post-cardiac injury syndrome

2022 ◽  
Author(s):  
Masahiro Kashiura ◽  
Takashi Moriya
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Cardiac Injury ◽  
Mesothelial Cells ◽  
Pericardial Space

Post-cardiac injury syndrome is caused by the combination of damage to pericardial mesothelial cells and blood in the pericardial space. We describe the case of post-cardiac injury syndrome after blunt chest trauma.

Cardiac Injury: Severe blunt chest trauma leads to cardiac arrest

2008 ◽  
Vol 33 (8) ◽  
pp. 36-36
Author(s):  
William Whalen ◽  
Daniel Holena ◽  
John P. Pryor
Keyword(s):  
Cardiac Arrest ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Cardiac Injury
Sign in / Sign up

Export Citation Format

Share Document