Elderly Smoker with Punctured Lung

Patient Bio  Brad  63 year old male  Smokes two or more packs of cigarettes a day  Already experiences lung dysfunction  Not very active

Injury and Symptoms  Fell on pile of wood with nails  Small puncture wound between ribs, heavy bruising  Immediate right chest pain  Severe trouble breathing, labored breathing (Dyspnoea)

Diagnosis  Diagnose with chest X-ray (patient) and/or physical exam  CT scan and/or ultrasound determines severity  Collapsed lung (Atelectasis)  Diagnosis: Punctured Lung (Pneumothorax)

Nature of Injury- Pneumothorax  Pleura- membrane layer, adheres to lung and thoracic wall  When air enters pleural space (from puncture) pleural adhesion is separated  Pressure increases, causes lung to collapse  Increased chance of occurrence in smokers

Pneumothorax, cont.  Without functioning lungs, CO increases in the blood  Effects oxygenation, leads to death  Air must be aspirated from pleural cavity to allow pressure to equalize, lung to inflate  Chest tube usually used

Chemical Engineering Intervention “Silicon Occlusive Dressing for Penetrating Thoracic Trauma”  Bandage covering the opening of the wound  Consists of: silicone impregnated gauze, thin plastic covering, adhesive (all air and fluid impermeable)  Packaged in paper, sterile, easily applied in the field

Adhere directly to the patient’s skin Complete bandage

Function  Acts as a temporary means of treatment in the field to prevent the collapsing of the lung  Side not adhered to patient works as a flutter valve  Changes in pressure either allow fluids (blood) to leave wound or disallow air into the wound

Pros and Cons of Silicon Dressing Pros  Easy to use in the field  Can be used in a variety of conditions affectively Cons  Only temporary- patient must still receive emergency care  Can fail by allowing improper amounts of air into wound  High rates of infection

Possible Improvements  Make the bandage more of a permanent fix  Increase durability of the adhesive, plastic coating  Make the packaging/application process more sterile  Decrease risk of infection

Brad’s Outcome  Brad was hospitalized so a chest tube could be inserted to refill his collapsed lung, given antibiotics  Had this dressing been used in the field, his lung may not have collapsed, less severe  Intervention reduces hospitalizations, recovery time, improves living chances