CHEST

TRAUM

A

SARAH FABIA

NO, MD

TODAYS LECTURE

-DISCUSS BASIC MECHANISMS OF CHEST TRAUMA

-DISCUSS CONCERNING CLINICAL FINDINGS OF CHEST TRAUMA

-STERNOCLAVICULAR JOINT DISLOCATION

-COMMOTIO CORDIS

CHEST TRAUMA In sports

According to a study published in Athletic Therapy Today in 2004, life threatening chest trauma in contact sports is rare, however the athletic trainer and sports physical therapist need to evaluate this quickly.

McGown AT. Blunt abdominal and chest trauma. Athletic Therapy Today. 2004;9(1):40–41

CAUSES OF CHEST TRAUMA

-COLLISION WITH ANOTHER PLAYER

-RUN INTO A STATIONARY OBJECT

-HIT BY AN OBJECT

TYPICAL S/S OF CHEST INJURY IN ATHLETES-DYSPNEA

-SIGNS OF SHOCK—THREADY PULSE, DIAPHORETIC

-FEELING OF “IMPENDING DOOM”

-HEMOPTYSIS

-DECREASED BREATH SOUNDS

-IRREGULAR PULSE

-TRACHEAL DEVIATION

-DISTENDED NECK VEINS

Careful examination of the chest wall

But this looks pretty good…

STERNOCLACVICULAR JOINT DISLOCATION

CLAVICLE INJURIES ARE COMMON AND CAN INCLUDE:

-FRACTURE

-AC JOINT SEPERATION

-SHOUDLER SEPERATION

A SC JOINT DICLOCATION IS SOMETHING NOT TO MISS….

Commonly happens in a pile up during football.

BEHIND THIS JOINT ARE VASCULAR AND AIRWAY STRUCTURES THAT CAN BE COMPROMISED

COMMOTIO CORDIS

-WHEN AN ATHLETE IS STRUCK IN THE CHEST BY AN OBJECT, BUT HAPPENS TO FALL AT THE BEGINNING OF THE T-WAVE OF THE CARDIAC CYCLE

COMMOTIO CORDIS

-ACCORDNG TO A STUDY BY MARON IN 1999, THE CASES THEY REVIEWED SHOWED THAT BASEBALL, SOFTBALL, AND ICE HOCKEY WERE THE MOST COMMON SPORTS.

-7/70 SURVIVED THE INJURY, 11/70 HAPPENED DESPITE CHEST PADDING

-THE KEY----AED----SHOCK, SHOCK, SHOCK

https://www.youtube.com/watch?v=LLtzT2bXVGI

Maron, Clinical profile of Commotio Cordis: An underappreciated cause of sudden death in the young during sports and other activities. Journal of Cardiovascular Electrophysiology. 1999.

KEY POINTS

-REMEMBER TO EXAMINE THE CHEST COMPLETELY

-REMEMBER THE CONCERNING SIGNS OF CHEST TRAUMA AND RE-EXAMINE THE ATHLETE

-COMMOTIO CORDIS---KNOW WHERE AND HOW TO USE THE AED

THANK YOU

sfabiano@ghs.org