KeysPhilly

In relation to being an EKG Technician, having an EKG Technician job or even attending to an EKG Technician Classes, pulmonary contusion is defined as focal injury with oedema, alveolar and interstitial haemorrhage. It is the most common potentially lethal chest injury. The respiratory failure may be subtle and develops over time rather than occurring instantaneously. Patients need careful monitoring and re-evaluation for several days after the injury. The initial presentation is usually with hypoxia and on the X-ray or CT, the pattern is of air space shadowing. This is normally non-segmental, often peripheral and adjacent to the area of trauma. Other causes of air space shadowing seen in trauma patients include aspiration, atelectasis and pulmonary oedema and it may be cardiogenic and non-cardiogenic.

Management is with oxygen therapy either with a positive pressure mask or mechanical ventilation. Due to the high force required to cause contusion there are often other accompanying injuries. In contrast, due to the increased compliance of the chest in children, pulmonary contusion can occur in the absence of rib fractures. Pulmonary laceration can occur secondary to shear forces in blunt trauma (Figs 3.7 and 3.8) or in penetrating injury. This is easy to miss if there is surrounding contusion. It is characterised by collections of air within surrounding contusion.