Pulmonary Contusion

WHAT YOU SHOULD KNOW:

• A pulmonary contusion is bruising of your lung tissue that may cause pain and trouble breathing. Your lungs are two sacs in your chest that get oxygen from the air you breathe. A pulmonary contusion is a common lung injury after a blunt (not sharp) trauma to your chest. The force of the trauma damages your lung cells, blood vessels, and other tissues. You may have fluid, such as blood, and swelling inside one or both of your lungs after the trauma. The blood and swelling in your lung forms the bruise that causes your pulmonary contusion.
  
  
• You may cough up blood, and have chest pain and trouble breathing. You may need a CT scan, x-ray or an ultrasound of the chest to learn about your pulmonary contusion. Blood tests that measure the oxygen in your blood may be done. You may be need oxygen given through a mask or through a tube connected to a breathing machine. Pain medicine and suctioning of secretions in your airways may help you breathe easier. Mild pulmonary contusions normally start to heal in 2 to 3 days. A mild pulmonary contusion may completely go away within 10 to 14 days. Treating your pulmonary contusion may resolve your breathing problems. Treatment may also resolve any chest injuries you have, and may save your life.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Medicines used to treat your pulmonary contusion may cause an allergic response. Your skin may breakdown in areas of pressure from the mask used to give you oxygen. You may also have abdominal (stomach) swelling from swallowing air when wearing an oxygen mask. You may have an increased risk of getting a lung infection if you need a breathing tube. Mucus in your lower airways may block air and cause your lung tissue to break down and bleed. Even with treatment, you are at risk of dying from the injuries causing your pulmonary contusion.
  
  
• If left untreated, a pulmonary contusion may cause your lung to fail or collapse. When this happens, your lung may not fill up with air, and you will have trouble breathing. You may also have an increased risk of getting a lung infection if your lungs do not work properly. Your event may have caused damage to your bones, spinal cord, airways, blood vessels, muscles, and heart. If your injuries are left untreated, you may bleed, stop breathing, and die. Talk to your caregiver if you are worried or have more questions about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Medicine:

• Pain medicine: Pain in your chest may keep you from breathing deeply and filling your lungs with enough air. Pain medicines may decrease your pain making it easier for you to breathe. You will be given pain medicine as a shot or in your IV. You may also receive pain medicines through an epidural which is a small tube inserted into your back.
  
  

Monitoring:

• Arterial blood gases: This test is also called an ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. The groin is the area where your abdomen meets your upper leg. Your blood is tested for the amount of oxygen, acids, and carbon dioxide it contains.
  
  
• Intake & output: Your caregivers may need to know the amount of liquid you are taking in. They may also need to know how much you are urinating. Careful monitoring of your liquids is important to prevent excess fluid from building up in your lungs.
  
  
• Pulse oximeter: A pulse oximeter is a machine that shows how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to the machine.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Tests:

• Computed tomography (CT) scan: A special x-ray machine with a computer will take pictures of your chest. The pictures will help caregivers see areas that may be bleeding and any broken bones.
  
  
• Chest x-ray: This is a picture of your heart and lungs. Your caregiver will use the pictures to look for bruises or other injuries in your lungs. It may take up to 6 hours after your injury before a pulmonary contusion can be seen on an x-ray. Other injuries in your chest may also cover the bruise, making it hard to find.

Treatment:

• Chest tube: A chest tube is used to remove air, blood, or fluid from around your lungs or heart. This lets your lungs fill up with air when you breathe, and helps your heart beat normally. A tube may be inserted through an incision (cut) in your chest to drain the air or fluid. The chest tube is attached to a container to collect the blood or fluid.
  
  
• Deep breathing and coughing: Deep breathing helps to open the air passages in your lungs. Coughing helps to bring up sputum (mucus) from your lungs. You can deep breathe and cough on your own, or with the help of an incentive spirometer.
  
  
  • Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep, strong cough. Put any sputum that you have coughed up into a tissue and throw it away. Take 10 deep breaths in a row every hour that you are awake, even during the night. Remember to follow each deep breath with a cough.
    
    
  • An incentive spirometer can help you take deeper breaths. Put the plastic piece into your mouth and take a steady, deep breath in. Hold your breath as long as you can, and then exhale (breathe out). Use your incentive spirometer 10 times every hour that you are awake, even during the night.
  
  
• Mechanical ventilation: If you cannot breathe properly, caregivers may put an endotracheal (ET) tube into your mouth and throat. The ET tube is a soft tube which keeps your trachea (windpipe) open and helps you breathe. The tube will be connected to a ventilator (breathing machine) to help you breathe and get enough oxygen.
  
  
• Non-invasive positive-pressure ventilation: Noninvasive positive-pressure ventilation, or NPPV, is a machine that will help you breathe. The machine helps your lungs fill with air by using a mask or a mouthpiece. If a mask is used, it may go over your nose and mouth, or just your nose.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen.
  
  
• Suctioning: Caregivers may insert a tube connected to a suction machine into your mouth, nasal passages, or ET tube. Suctioning is done to remove any blood or mucus that is blocking your air passages.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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