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ITLS Signs, Symptoms and TreatmentComment on this pageEdit this page

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InjuryBlood PressurePulseResp (Quality)SkinJVDLung SoundsHeart SoundsCommentsTreatmentOxygen
PneumothoraxNormal to Low↑ (shallow)Pale↓ (one side)If open - 3 sided bandage,
rapid TPT
Yes
Tension Pneumothorax↑ (shallow)PaleYes↓ (one side)Rapid TPTYes
Flail ChestNormal↑ (due to pain)↑ (shallow)Pale↓ (and Paradoxial Motion)Manual stabilization or
Bulky dressing
Yes
Cardiac ContusionNormal - PaleClearNormalRecognition,
rapid TPT
Yes
Cardiac Tamponade↑ (thready)↑ (shallow & irregular)Pale - Cool - ClammyYesClearMuffledRecognition,
rapid TPT
Yes
ICP↑ (rises over 3 readings)↓ (bounding)IrregularPale - Cool - ClammyClearRecognition,
rapid TPT
Yes (possibly hyperventilate)
Aortic Rupture↓↓↓↑↑↑Pale - Cool - ClammyClearRecognition,
rapid TPT
Yes
Neurogenic Shock
(Relative Hypovolemia, Vasodialatory Shock)
LowInappropriate to circumstancesNormal / Warm / Pink and DryClearExpect neurological deficitsRecognition,
rapid TPT
Yes
Cardiogenic Shock (shock resulting in inadequate supply of blood to heart)LowPale - Cool - ClammyClearRecognition,
rapid TPT
Yes
Hypovolemia / TraumaLowPale - Cool - ClammyClearStop external bleeding,
rapid TPT
Yes
Massive HemothoraxLowRapidPale - Cool - ClammyAbsent on affected side
(dull to percussion)
Recognition,
rapid TPT
Yes

Hyperventilation

There are very specific circumstances when we would use hyperventilation (BVM @ 20 for adults) to treat a patient suffering from ICP.

  • Cushings reflex must be present, AND
  • The patient must have a GCS less than 9 or GCS dropping 2 points between vitals, AND/OR
  • Blown pupil(s)

Cushings Triad = Hypertension + Bradycardia (bounding) + Irregular Respirations
Becks Triad = Hypotension + Muffled Heart Sounds + JVD