Respiratory Care of Thoracic Injuries Research Paper

Respiratory Care of Thoracic Injuries Research Paper


According to statistics 260 million vehicles were registered in the USA in 2014 (Number of vehicles registered in the United States from 1990 to 2014, n.d.). This enormous amount proves the existence of the great demand and poses a threat to peoples security. The fact is that any vehicle could be considered dangerous for people. The same statistics evidence that thousands of people die from motor vehicle car accidents (MVA) annually (Number of vehicles registered in the United States from 1990 to 2014, n.d.). Respiratory Care of Thoracic Injuries Research Paper

Additionally, a number of individuals suffer from serious injuries and other complications that deteriorate the quality of their lives. Besides, the existence of the given problem conditions the rapid evolution of the spheres and tools that are aimed at the provision of help and assistance for those who suffered from the road traffic accident and became injured. The health care sector could be considered one of these fields that provided numerous tools and practices to guarantee an individuals existence and improve his/her quality of life.Respiratory Care of Thoracic Injuries Research Paper


As stated above, road traffic accidents could be considered one of the main causes of death in the modern age (Murty & Ram, 2012). Yet, the character of traumas peculiar to this sort of patients predetermined the appearance of certain practices needed to help people and protect their lives. Besides, at the moment phrenic nerve paralysis, diaphragmatic injuries, and thoracic cage injuries could be considered the main characteristics of an individual who experienced a motor vehicle accident (Murty & Ram, 2012).

For this reason, the modern health care sector provides numerous approaches to the treatment of these very traumas. Furthermore, there are many researchers and investigations that revolve around the given issue and provide their own approaches and solutions to the given problem. The significance of these traumas and efficiency of some approaches are proven by the increased success rates peculiar to medical establishments that are specialized on the provision of the needed care for patients.

Phrenic nerve paralysis


Nevertheless, the great percentage of road tolls suffer from serious problems with respiration. In the majority of cases, the accident of this sort is characterized by a strong stroke in the thoracic region which might result in phrenic nerve paralysis, diaphragmatic and thoracic cage injuries (Murty & Ram, 2012). These problems could also cause a great threat to the patients health and be one of the main causes of death. That is why there are numerous approaches to the way these very patients should be treated. However, provision of the respiratory care is one of the main tasks that arise from the nature of trauma and the patents basic needs. In other words, there is the great necessity of the breathing management to guarantee a patients survival. However, the care should consider the character and complexity of trauma.

Literature Review

If to speak about the above-mentioned problems, phrenic nerve paralysis could be considered rather common. The crash and strong stroke might result in the palsy of this very nerve and condition the appearance of numerous respiratory problems. For this reason, it is crucial to assure that a patient will be able to breathe and initiate the procedure of treatment. The complexity of the trauma and issue comes from the great significance of the given nerve and its impact on the whole respiratory system. There are numerous approaches to the treatment as its results determine the terms of the patients recovery and his/her further living. That is why it is crucial to investigate the main existing approaches to obtain the clear image.

Yet, the modern medical science provides several approaches to this problem. Tsakiridis et al. state that phrenic nerve paresis is one of the main traumas appearing after serious crashes (2012). For this very reason, it is vital to apply the modern and efficient surgical treatment that could help a patient recover and improve the quality of life.

The authors state that there are several techniques and approaches that are employed for diaphragmatic plication which are thoracotomy, video-assisted thoracoscopic surgery, video-assisted mini-thoracotomy, laparoscopic surgery (Tsakiridis et al., 2012). These practices are needed to provide respiratory care for this sort of patients and help them to recover. However, the researchers also state that the efficiency of these approaches could be impacted by the general state of the patient’s health.

Furthermore, Liu et al. (2015) underline the great threat of phrenic nerve paralysis and the necessity of the efficient treatment. They tend to consider phrenic nerve transfer the main dynamic treatment that could be used to avoid problems with respiration (Liu et al., 2015). In numerous cases, the character of the injury from which a patient suffers, introduces the great necessity of the above-mentioned transfer as it could hardly be restored by means of the modern medicine. That is why this approach could be used in the most complicated situations when there is no perspectives and possibilities for other treatment. The great potential risk of surgery is compensated by the expected positive outcomes.

Goff, Spencer, and Jaizzo (2016) also suggest several approaches to treatment. They are sure that phrenic nerve injury can be a significant complication of any road traffic accident (Goff et al., 2016). Considering their frequency, the creation of the efficient approach to treatment could be considered an important task of the modern healthcare sector. Additionally, it is vital to obtain the clear image of the harm done to this very nerve. Researchers highlight the importance of MRI and creation of the computer model to analyze its current state and prescribe the procedures needed to guarantee a patients recovery. Yet, it is extremely vital to assure that all patients will be able to breathe independently and recover from the injury.

Nevertheless, the idea of nerve transport is supported by Al-Qattan and El-Sayed in their paper. They are sure that the provision of the respiratory care for patients should be followed by the phrenic nerve transplantation as only this measure could guarantee patients complete recovery. The authors state the fact that the “phrenic nerve in healthy adults does not result in any clinically significant problems” (Qattan & El-Sayed, 2014, para. 4) and could not condition some troubles with aspiration.

For this reason, “entire phrenic nerve is commonly sacrificed and used for nerve transfer” (Qattan & El-Sayed, 2014, para. 5) in complicated cases. To solve various problems with aspiration among victims of MVA this very measure could be recommended. It might help to mitigate the negative aftermath of this very accident and improve the quality of the patents life greatly.

Finally, speaking about the problems with the phrenic nerve that appear after the traffic accident, one should consider the fact that a number of researchers also tend to accept the idea that the successful provision of respiratory care depends on the state of this very nerve. The patient might experience serious problems with breathing and have the need for intubation, lung ventilation, and some extra medical equipment. It is crucial to guarantee the timely and efficient usage of the needed devices. Besides, there is the possibility to implant a nerve stimulator that will control its functioning and guarantee the patients recovery. The electrode placed next to the phrenic nerve will help a patient to breathe and result in the significant improvement of his/her current state.

Diaphragmatic injuries


Besides, diaphragmatic injuries might also accompany the above-mentioned symptoms and pose a great threat to the patients life. The given kind of trauma might introduce significant deterioration of the respiration process and result in an individuals death. For this reason, numerous investigators and therapists admit the great role this very injury might play in the process of delivery of respiratory care. One should give great attention to the problem because of its extreme importance. Diaphragmatic injuries could result in the decrease of respirations and even death. Under these conditions, a specialist should be able to consider its problems and create the most appropriate care pattern. There are several important methods suggested by scientists in numerous researches.

Literature Review

Yet, Sersar, Albohiri, and Abdelmohty (2016) are sure that any penetrating chest trauma might condition the appearance of diaphragmatic injuries and problems with respiration. Additionally, the problem is complicated by the existence of other factors that might impact the functioning of a diaphragm and predetermine the respiratory standstill. For this reason, a specialist should mind all factors that impact this very aspect and guarantee the provision of the respiratory care to assure that a patient will be able to survive and recover.

The fact is that there is the great need for some additional devices and equipment that could help a team of specialists. Furthermore, there could also be the necessity to use surgery to promote the patients recovery. The identification of the most problematic areas is crucial for patients who experience problems with respiration.

Diaphragmatic injuries also might be considered the problem that appears in the majority of accidents. Panda et al. (2014) assume that blunt and or penetrating traumas pose a great threat to patients security and should be treated in accordance with a certain procedure needed to guarantee the patients fast recovery. They are sure that the diaphragmatic injuries have been found in a number of individuals who experienced severe clashes. At the same time, respiratory problems could be observed when working with these traumas. For this reason, the analysis of vitals and provision of the efficient and high-quality health care is crucial to help individuals who suffer from this very problem. Respiratory Care of Thoracic Injuries Research Paper

Thiam et al. emphasize the fact that thoracoabdominal blunts or traumas might result in the appearance of the above-mentioned injuries. However, there is a certain problem related to diagnosing as it is often delayed (Thiam et al., 2016). The usage of various devices could not serve as the guarantee of the correct identification of the problem. Yet, the surgical management remains one of the most efficient treatments used in these cases. The researchers are also sure, that to mitigate the negative impact of the incident and help a patient it is vital to act immediately and identify the main reasons that result in the problems with respiration (Thiam et al., 2016).

Only under these conditions, the gradual and efficient recovery process could be initiated. Additionally, there is the great need for the usage of the appropriate approaches to guarantee the coherent analysis of the situations and reasons that caused the injury.Respiratory Care of Thoracic Injuries Research Paper

Nevertheless, management of the patients who suffer from the traumatic injury of the diaphragm could be complex as there is a great need for the unusual approaches and extra resources. Hwang, Kim and Byun (2011) state that there is a certain set of factors that might affect the incidence of complications and mortality in patients with the given problem. The great threat of this sort of trauma is also proven by numerous companion problems that appear when treating a patient of this sort. Hwang et al. (2011) are sure that to restore the respiration it is crucial to use operative treatment and accomplish the diaphragm’s restoration and help patients to recover. Yet, these surgeries could also be dangerous because of its great complexity.

At the same time, Bas et al. (2015) state that the reparation of traumatic diaphragmatic injuries and breathing management could be performed by means of synthetic mesh. It could be used to repair the injuries of the diaphragm and guarantee the patients survival.Respiratory Care of Thoracic Injuries Research Paper

They also tend to consider surgical intervention to be the only possible way to help a patient. However, there are still several crucial points that appear while providing respiratory care to a patient. A patient might die because of the unexpected complications that occur when trying to guarantee the diaphragm recovery. For this reason, the main task of any modern healthcare specialist is to assure that a patient perceives the needed care and could endure the treatment and surgery. There could be the need for some special equipment and medical devices.Respiratory Care of Thoracic Injuries Research Paper

Thoracic cage injury

Besides, thoracic cage injury is another common problem that occurs among patients who experienced motor-vehicle accident. A high impact and the great energy of a car results in the appearance of numerous traumas. Considering the character of these very accidents, one could accept the fact that chest is one of the parts of the body that are subjected to a great threat. Statistics show that 80% of victims suffer from thoracic cage injury that could result in significant problems with respiration. For this reason, there the great need for the provision of the efficient respiratory care.

Literature review

Cogitating around the given issue, Bailey et al. (2012) state that the complexity of these traumas might be considered the main issue related to the given sphere. Thoracic cage injury is taken as potentially life-threatening as it covers such important organs as the heart, lungs, liver, etc. In this regards, efficient treatment is one of the key aspects needed to guarantee success. Yet, the authors tend to consider the provision of the respiratory care the most important concern. Moreover, there is the need for some extra actions aimed the patients state improvement.Respiratory Care of Thoracic Injuries Research Paper

Yet, Chaudhary, Roselli, Steinmetz, and Mroz (2012) proclaim that problems with respiration are one of the main factors that should be given greatest attention while trying to save patients lives and improving their current state The character of trauma might imply the significant deterioration of the patient’s health. The fact is that the traumatic chest injury could be considered a major cause of mortality and morbidity in patients. Moreover, the proximity of aorta, heart, and lungs increases the risk of severe complications and introduces the necessity of some extra measures.


Dongel, Coskun, Ozbay, Bayram and Atli (2013) also adhere to the above-mentioned idea. They are sure that only in terms of the efficient breathing management and immediate interventions some visible results could be achieved. For this reason, patients with thorax traumas caused by motor vehicle accidents should be given great attention. It is crucial to provide the precise and comprehensive analysis of all factors the impact his/her health and assure that he/she will be able to obtain oxygen as needed. Besides, it could be considered the complicated task in case ribs or some internal parts of the body are damaged.Respiratory Care of Thoracic Injuries Research Paper

Reviewing the literature devoted to this very topic, Chotai and Abdelgawad (2014) highlight the fact that thorax traumas might appear because of various reasons. However, a stroke in the chest is one of the most frequent cases that result in the appearance of complex problems. For this reason, almost any motor vehicle accident results in a serious injury that might prevent a patient from breathing. Under these conditions, the breath management is essential to guarantee his/her survival and assure that there will be the opportunity to continue recovery and help a patient to.recuperate.

As stated above, the efficient usage of the needed equipment is the key to the complete recovery. The artificial lung should be used to provide the needed oxygen and support a patient. Furthermore, the alarm system should also be introduced to warn specialists and inform them about the appearance of some emergency. All workers of the intensive care unit should be able to work with the given equipment and ready to respond to the slightest oscillations in the patients vitals. At the same time, there is the great need for the usage of some extra approaches in case there is a tendency towards the worsening of the current situation.

Finally, the modern health science tends to accept complications that appear after MVA as a great threat to the patients health (Blyth, 2014). For this reason, it provides numerous possibilities for their investigation and precise analysis. The usage of MRI and other scanning devices might provide the clear image of the current situation and help therapists to introduce the needed treatment. Moreover, there is the tendency towards the appearance of the new methods to work with these very traumas to mitigate the negative impact of the above-mentioned accidents and guarantee the patients recovery (Ustaalioglu 2015). Respiratory Care of Thoracic Injuries Research Paper


In conclusion, phrenic nerve paralysis, diaphragmatic injuries and thoracic cage injury could be considered the most dangerous concerns peculiar to patients who experienced road traffic accidents and needed recovery badly. That is why the modern science provides a number of approaches aimed at the provision of the most efficient treatments and procedures. However, there are still various perspectives that exist on the way how this sort of traumas should be cured to guarantee the patients survival.

In these regards, breathing management and provision of respiratory care for victims of traffic accidents is an important task that predetermines the success of the whole recovery process. The investigation of the credible sources proves the idea that thoracic injuries are extremely dangerous for patients and should be treated immediately. Respiratory Care of Thoracic Injuries Research Paper


Bailey, J., Heiden, T., Burlew, C., Sibbel, S., Jordan, J., Moore, E.,…Stahel, P. (2012). Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury. World Journal of Emergency Surgery, 7,14. Web.

Bas, G., Ozkan, V., Alimoglu, O., Eryilmaz, R., Sahin, M., Okan, I.,…Cevikbas, U. (2015). The role of n-butyl-2-cyanoacrylate in the repair of traumatic diaphragmatic injuries. International Journal of Clinical and Experimental Medicine, 8(4), 5876-5882. Web.

Blyth. A. (2014). Thoracic Trauma. BMJ, 348. Web.

Chaudhary, S., Roselli, E., Steinmetz, M., & Mroz, T. (2012). Thoracic Aortic Dissection and Mycotic Pseudoaneurysm in the Setting of an Unstable Upper Thoracic Type B2 Fracture. Global Spine Journal, 2(3), 175-182. Web.

Chotai, P., & Abdelgawad, A. (2014). Tug-of-War Injuries: A Case Report and Review of the Literature. Case Reports in orthopedics, n.pag. Web.

Dongel, I., Coskun, A., Ozbay, S., Bayram, M., & Atli, B. (2013). Management of thoracic trauma in emergency service: Analysis of 1139 cases. Pakistan Journal of Medical Sciences, 29(1), 58-63. Web. Respiratory Care of Thoracic Injuries Research Paper

Goff, R., Spencer, J., & Jaizzo, P. (2016). MRI Reconstructions of Human Phrenic Nerve Anatomy and Computational Modeling of Cryoballoon Ablative Therapy. Annals of Biomedical Engineering, 44, 1097-1106. Web.

Hwang, S., Kim, H., & Byun, J. (2011). Management of Patients with Traumatic Rupture of the Diaphragm. The Korean Journal of Thoracic and cardiovascular surgery, 44(5), 348-354. Web.

Liu, Y., Xu, X., Zou, Y., Li, S., Zhang, B., & Wang, Y. (2015). Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury: electrophysiological characteristics. Neural Regeneration Research, 10(2), 328-333. Web.

Murty, V., & Ram, K. (2012). Phrenic nerve palsy: A rare cause of respiratory distress in newborn. Journal of pediatric neurosciences, 7(3), 225-227. Web.

Number of vehicles registered in the United States from 1990 to 2014. (n.d.). Web.

Panda, A., Kumar, A., Gamanagatti, S., Patil, A., Kumar, S., & Gupta, A. (2014). Traumatic diaphragmatic injury: a review of CT signs and the difference between blunt and penetrating injury. Diagnostic and Interventional Radiology, 20(2), 121-128. Web.

Qattan, M., & El-Sayed, A. (2014). The Use of the Phrenic Nerve Communicating Branch to the Fifth Cervical Root for Nerve Transfer to the Suprascapular Nerve in Infants with Obstetric Brachial Plexus Palsy. BioMed Research international, 348. Web.

Sersar, S., Albouhiri, K., & Abdelmothy, H. (2016). Impacted thoracic foreign bodies after penetrating chest trauma. Asian Cardiovascular and Thoracic Annals, n. pag. Web.Respiratory Care of Thoracic Injuries Research Paper

Thiam. O., Konate, I., Gueye, M., Omar, T., Seck, M., Cisse, M.,…Toure, C. (2016). Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects. Springerplus, 5(1), 1614. Web.

Tsakiridis, K., Visouli, A., Zarogoulidis, P., Machairiotis, N., Christofis, C., Stylianaki, A.,…Zarogoulidis, K. (2012). Early hemi-diaphragmatic plication through a video assisted mini-thoracotomy in postcardiotomy phrenic nerve paresis. Journal of Thoracic Disease, 4(1), 56-68. Web.

Ustaalioglu, R., Yildirim, M., Cosgun, H., Dogusoy, I., Imamoglu, O., Yasaroglu, M.,…Okay, T. (2015). Thoracic Traumas: A Single-Center Experience. Turkish Thoraric Journal, 16(2), 59-63. Web. Respiratory Care of Thoracic Injuries Research Paper