Ver el código de «Traumatic asphyxia»

==Background==
*Traumatic asphyxia occurs when sudden and blunt chest trauma forces  retrograde flow of blood  through the superior vena cava and into the neck and head.
*Normally a result of blunt chest trauma from an MVA <ref>Centers for Disease Control and Prevention. Accidents or unintentional injuries. http://www.cdc.gov/nchs/fastats/accidental-injury.htm</ref>
*In children the chest wall is more pliable and there is often less morbidity unless there is also multiorgan trauma<ref>Gutierrez IM, Ben-Ishay O, Mooney DP. Pediatric thoracic and abdominal trauma. Minerva Chir. Jun 2013;68(3):263-74</ref>

==Prehospital==
*Maintain adequate oxygenation > 92%
*Maintain blood pressure with small fluid boluses if necessary (250cc boluses)
*Assess for tension pneumothorax if patient hypoxic or hypotensive
**Perform [[Needle thoracostomy]] if indicated
*Prepare for [[Advanced Airway]] if patient persistently hypoxic, unable to maintain airway, or has an anticipated poor clinical course

==Clinical Features==
[[File:PMC4458292 CRIEM2015-359814.001.png|thumb|Traumatic asphyxia patient with (a) bilateral subconjunctival hemorrhage; (b) facial cyanosis, petechial eruptions on the anterior surface of the thoracic cage and on left upper extremity.]]
[[File:PMC2992570 kjo-24-380-g001.png|thumb|Traumatic asphyxia with severe bilateral subconjunctival hemorrhages, chemosis, severe eyelid swelling, and mild exophthalmos.]]
[[File:PMC3047851 12245 2010 204 Fig1 HTML.png|thumb|A patient with traumatic asphyxia. The head, neck, and upper chest are strikingly cyanotic and edematous, with multiple petechiae; he also had bilateral subconjunctival hemorrhages and bilateral hemopneumothorax.]]
[[File:PMC2840592 12245 2009 115 Fig1 HTML.png|thumb|A patient with traumatic asphyxia: diffuse petechiae and purpura throughout face and eyelids and submucosal hemorrhages on the lower lip.]]
Many of the following features can be seen on exam depending on the extent of the force.<ref> Hubble MW, et al. Chest Trauma. In Hubble MW, Hubble JP, eds, Principles of Advanced Trauma Care. Albany, NY: Delmar/Thompson Learning, 2002.</ref>
*Upper-extremity cyanosis
*Bilateral subconjunctival hemorrhage
*Facial and neck edema
*Engorged tongue

===Signs and Symptoms===
*Chest wall bruising or significan tmechanism consistent with thoracic trauma (i.e. seatbelt sign, steering wheel deformity, airb deployment)
*[[Arrhythmia]]
*Impaired blood flow to the brain can cause
**may result in [[Neurologic_exam|neurologic deficits]], [[AMS|altered mental status]], or [[Seizures]]
**[[ICH|Hemorrhagic]] [[Stroke (Main)|CVA]] is unlikely

==Differential Diagnosis==
{{Thoracic trauma DDX}}

==Evaluation==
[[File:PMC3441877 1752-1947-6-257-2.png|thumb|CT chest of a patient with traumatic asphyxia showing bilateral hemopneumothorax and multiple lung contusions, especially on the right.]]
*[[Chest X-ray]]
**although often little diagnostic yield<ref>Cook AD, Klein JS, Rogers FB, et al. Chest radiographs of limited utility in the diagnosis of blunt traumatic aortic laceration. J Trauma. May 2001;50(5):843-7</ref>
**used to assess for gross [[Pneumothorax]], [[Rib fracture]], or mediastinal widening concerning for [[Aortic Dissection]] or [[Pulmonary Contusion]]
*CT with IV contrast for better assessment of lung and vasculature

==Management==

==See Also==
*[[Thoracic Trauma]]
*[[Cardiac contusion]]

[[Category:Pulmonary]]
[[Category:Trauma]]

==References==
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