Advanced Trauma Life Support ATLS Student Course Manual 2018

Skill Station B
BREATHING
LEARNING OBJECTIVES
1. Assess and recognize adequate ventilation and
oxygenation in a simulated trauma patient.
2. Identify trauma patients in respiratory distress.
3. Practice systematically reading chest x-rays of
trauma patients.
4. Recognize the radiographic signs of potentially lifethreatening
traumatic injuries.
5. Identify appropriate landmarks for needle
decompression and thoracostomy tube placement.
6. Demonstrate how to perform a needle
decompression of the pleural space on a simulator,
task trainer, live anesthetized animal, or cadaver.
7. Perform a finger thoracostomy using a simulator,
task trainer, live anesthetized animal, or cadaver.
8. Insert a thoracostomy tube using a simulator, task
trainer, live anesthetized animal, or cadaver.
9. Discuss the basic differences between pediatric
chest injury and adult chest injury.
10. Explain the importance of adequate pain control
following chest trauma.
11. List the steps required to safely transfer a trauma
patient with a breathing problem.
••
Breathing Assessment
••
Interpretation of Chest X-ray
••
Finger and Tube Thoracostomy
••
Needle Decompression
••
Use of Pediatric Resuscitation Tape
STEP 1.
Skills Included in this
Skill Station
Breathing Assessment
Listen for signs of partial airway obstruction
or compromise.
••
Asymmetrical or absent breath sounds
••
Additional sounds (e.g., sounds indicative
of hemothorax)
STEP 2. Look for evidence of respiratory distress.
••
Tachypnea
••
Use of accessory muscles of respiration
••
Abnormal/asymmetrical chest wall
movement
••
Cyanosis (late finding)
STEP 3. Feel for air or fluid.
••
Hyperresonance to percussion
••
Dullness to percussion
••
Crepitance
Interpretation of chest
x-RAy
The DRSABCDE mnemonic is helpful for interpreting
chest x-rays in the trauma care environment:
n BACK TO TABLE OF CONTENTS
345