Question

CLINICAL CA RESPIRATORY SYSTEM When she was freed from the Barbara Joley was in the bus that was hit broadside. wreckage, she was deeply cyanotic and her respiration had sand thready Her heart was still beating, but her pulse wasa She had a fracture at the level of the C2 vertebra. Right thorax compressed; ribs 7 to 9 fractu Right lung atelectasis 4 red 4 Questions . What procedures should be initiated immediately by the emergency personnel? . Why is she cyanotic? . What might have happened to cause Barbara's cessation of breathing? Why only the right lung is affected by atelectasis? What is the mechanism of atelectasis? What treatment will be done to reverse the atelectasis?

Answer 1

1. The fracture C2 vertebra leads to compression and damage of the spinal cord at the level of vertebra. This leads to paralysis of diaphragm and other muscles breathing due to damage to nerves. This is the cause for cessation breathing.

2. The immediate management includes :

- immobilization of the neck and spine in neutral position

- immobilization of the chest

- maintain airways. Check for any obstruction in airway and clear it if present.

- maintain the breathing providing artificial oxygenation through oxygen mask or other devices

3. Cyanosis is defined as bluish discolouration of the skin and mucous membrane to low oxygen saturation. The patient is cyanotic because with the cessation of breathing amount of oxygen reaching the tissue cells have decreased or absent. Cyanosis occurs due to low oxygen saturation of the blood.

4. Atelectasis is defined as the collapse of the lung. Atelectasis developed only on right side of lung because the lung is compressed on right side. The compression leads to obstruction of airway and bronchioles on the right side which reduces the lung volumes. This leads to collapse of the alveoli resulting in atelectasis.