Hello, med students. My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship Podcast.

Today we are still continuing our trauma series. We've done head, face, c spine, neck. Today we are starting chest here's our case

hey dr olson this is a John 47 year old framer at a construction site

looks like one of the other workers was using a modified nail gun which fired hit on in the right lower and to your chest

we did mark the area there was no exit wound had initial decreased breast sounds on the

right side and was satting at about 91% applied an inclusive dressing put him on 15

liters of 02 not much of an improvement didn't needle thoracomy, improved to 95% and was mentating well the entire time.

Vital signs BP 160 over 90, pulse of 120, respirations of 18.

Blue Postal 112 has a history of hypertension and diabetes.

Does not take any meds, has no allergies, and here's a sample of the nail that was inside of the guns.

Yeah.

I know, right.

Okay, John, good luck.

Good luck to you.

Chest injury. Now, here's the deal with chest injury. There's a lot, a lot, a lot to cover.

And I've actually struggled with how to teach this and condense it down. And so the way I'm going to do it is this topic will take two weeks.

This episode will cover lungs stuff, ribs stuff. Next episode will cover

cardiovascular stuff because there's just too much here to cover in less than 10 minutes.

The most important thing to remember today are the three critical diagnoses that you need to be

putting in every chest injury presentation.

Tension pneumothorax, open pneumothorax, and hemothorax.

Let's go through a quick approach first, and then we'll dive into each of these individually.

...