ITLS Signs, Symptoms and TreatmentComment on this page
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Injury | Blood Pressure | Pulse | Resp (Quality) | Skin | JVD | Lung Sounds | Heart Sounds | Comments | Treatment | Oxygen |
---|---|---|---|---|---|---|---|---|---|---|
Pneumothorax | Normal to Low | ↑ | ↑ (shallow) | Pale | ↓ (one side) | If open - 3 sided bandage, rapid TPT |
Yes | |||
Tension Pneumothorax | ↓ | ↑ | ↑ (shallow) | Pale | Yes | ↓ (one side) | Rapid TPT | Yes | ||
Flail Chest | Normal | ↑ (due to pain) | ↑ (shallow) | Pale | ↓ (and Paradoxial Motion) | Manual stabilization or Bulky dressing |
Yes | |||
Cardiac Contusion | Normal - Pale | Clear | Normal | Recognition, rapid TPT |
Yes | |||||
Cardiac Tamponade | ↓ | ↑ (thready) | ↑ (shallow & irregular) | Pale - Cool - Clammy | Yes | Clear | Muffled | Recognition, rapid TPT |
Yes | |
ICP | ↑ (rises over 3 readings) | ↓ (bounding) | Irregular | Pale - Cool - Clammy | Clear | Recognition, rapid TPT |
Yes (possibly hyperventilate) | |||
Aortic Rupture | ↓↓↓ | ↑↑↑ | ↑ | Pale - Cool - Clammy | Clear | Recognition, rapid TPT |
Yes | |||
Neurogenic Shock (Relative Hypovolemia, Vasodialatory Shock) |
Low | Inappropriate to circumstances | Normal / Warm / Pink and Dry | Clear | Expect neurological deficits | Recognition, rapid TPT |
Yes | |||
Cardiogenic Shock (shock resulting in inadequate supply of blood to heart) | Low | ↑ | ↑ | Pale - Cool - Clammy | Clear | Recognition, rapid TPT |
Yes | |||
Hypovolemia / Trauma | Low | ↑ | ↑ | Pale - Cool - Clammy | Clear | Stop external bleeding, rapid TPT |
Yes | |||
Massive Hemothorax | Low | Rapid | ↑ | Pale - Cool - Clammy | Absent 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