Editing Trauma - airway/breathing (section)

== VENTILATION ==
Move onto ventilation once airway has been cleared.

Can be compromised by airway obstruction, altered ventilatory mechanics, or CNS depression

# Problem recognition

* Direct trauma to chest causes pleuritic pain - poor ventilation - rapid, shallow breathing
* Intracranial injury - abnormal breathing patterns
* C-spine injury - paralysis/paresis
** Injuries below C3 will leave diaphragm intact but compromise intercostal/abdo muscle contribution
*** Seesaw pattern - abdomen pushed out with inspiration, lower ribcage pulled in
*** "abdominal breathing" or "diaphragmatic breathing"

# Objective signs of inadequate ventilation

* Look for symmetry
** Asymmetry - splinting of rib cage, PTX, flail chest
* Listen for movement of air on both sides
* Use pulse oximeter
** Consider hypoperfusion or shock with low sats
* Use capnography when intubated


Airway decision scheme: