PHTY300 Lecture Notes - Lecture 6: Particulates, 48Hours, Subcutaneous Emphysema

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26 Jul 2018
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Acid (gastric contents: disruption of alveolar-capillary membrane, destruction of bronchial & alveolar cells. Intrapulmonary shunting: near drowning, fresh water / sea water, surfactant denatured, disrupts alveolar-capillary membrane (pulmonary. Only steam is capable of inflicting direct thermal damage. Most injury is caused by incomplete products of. Chest wall blunt trauma: rib, flail segment, sternal , diaphragm rupture. Decreased movement of ribs (or paradoxical: gas movement (o2) = decreased pao2. Localised (contused area: gas movement (co2) = increased paco2. Load ability to cope with load. Efficiency: secretion movement (secondary effect) Short-term effects of contusion: activation of coagulation cascade. Impaired lung function: local in static lung compliance, o2 movement. Impaired vc (altered mechanics/ pain: frc, pefr, chest wall deformity. Pulmonary contusion: bruised lung not confined to anatomical segments, becomes more oedematous over first 48hours, ct: pulmonary infiltration + consolidation, alveolar haemorrhage (blood pneumonia) without significant interstitial injury contusion on admission. No evidence of hf, fluid overload or chronic lung disease.

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