Barbara Joley was in the bus that was hit broadside. When she was freed from the
ID: 93654 • Letter: B
Question
Barbara Joley was in the bus that was hit broadside. When she was freed from the wreckage, she was deeply cyanotic and her respiration had stopped Her heart was still beating, but her pulse was fast and thready She had a fracture at the level of the C2 vertebra. Right thorax compressed: ribs 7 to 9 fractured Right lung atelectasis 1. What might have happened to cause Barbara's cessation of breathing? 2. What procedures should be initiated immediately by the emergency personnel? 3. Why is she cyanotic? 4. Why only the right lung is affected by atelectasis? 5. What is the mechanism of atelectasis? 6. What treatment will be done to reverse the atelectasis?Explanation / Answer
1) Spinal cord injury from a fracture at the level of the C2 vertebra would interrupt the ordinary transmission of signals from the brain stem down the phrenic nerve to the diaphragm, and Barbara would be unable to breathe due to paralysis of the diaphragm.
2) Her head, neck, and torso should have been immobilized to prevent in addition damage to the spinal wire. In addition, she required help to breathe, so her airway became probably intubated to allow air flow of her lungs.
3) Cyanosis is a decrease in the diploma of oxygen saturation of hemoglobin. As her respiration efforts give up, her alveolar Po2 will fall, so there's much less oxygen to load onto hemoglobin. In her peripheral tissues, what little oxygen hemoglobin incorporates might be fed on, leaving these tissues with a bluish tinge.
4) Because it's far the proper thorax that is compressed, simplest her proper lung is affected. Because the lungs are in separate pleural cavities, right lung collapsed.
5) Atelectasis is the disintegrate of a lung.
6) The atelectasis will be reversed by means of placing a chest tube and disposing of the air shape the pleural cavity. This will permit her lung to heal and reinflate
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