GSW Case Study - Glossary

Comminuted -- a broken or shattered area, in this case, referring to an area of bone shattered by a bullet.

Fibula - the lateral and smaller of the two bones of the leg; it articulates with the tibia above and the tibia and talus below.

Amputate -- pruning or cutting off a limb or part of a limb.

Chest Tube -- a tube placed into the pleural cavity to evacuate either blood, pus, fluid, and or air.

Lobectomy -- excision of a lobe of any organ, referring in this case to the removal of the right upper and right middle lobes of the lung.

Pulmonary Edema -- excess fluid accumulates in the lungs causing gas exchange to be interrupted, this is occurring because fluid is filtered into the lungs faster than it can be removed.

Hemorrhaged -- an escape of blood from the blood vessels, referring in this case to a loss of blood due to the bullet penetrating the victim's thorax.

Endotracheal tube -- a tube placed into the trachea to allow for manual or machine given breaths.

Ventilator -- a device that provides a bulk movement of gas into the lungs during inspiration. Either gas volume or gas pressure is controlled by the machine to deliver a tidal breath at a preset frequency. Exhalation is usually passive.

Positive End-Expiratory Pressure (PEEP) -- the application of positive airway pressure to maintain alveolar stability by leaving a certain amount of air in the lungs after expiration has occurred. PEEP improves oxygenation provided the cardiac output is not reduced.

Arterial Blood Gas (ABG) -- the measurement of oxygen and carbon dioxide partial pressures and blood pH from a sample of arterial blood. Assesses ventilation and oxygenation.

Crackles (Rales) -- a discontinuous, high or low-pitched breath sound usually heard during inspiration.

Nebulizer --a device which produces small aerosol particles used to deliver medication via inhalation.

Auto-PEEP -- positive pressure in the airway due to incomplete emptying of the lungs at the start of the next breath.

Patient Wye -- that section of a ventilator circuit where the inspiratory and expiratory limbs connect to the patient's endotracheal or tracheostomy tube.

Rhonchi --a musical and continuous vibration, consisting of low or high pitch breath sounds. It usually occurs on expiration.

Red Man's Syndrome --a flushing of the face and neck due to rapid infusion of the drug Vancomycin. Pruritis and hypotension are also seen.

Disseminated intravascular coagulation --a systemic clotting disorder caused by widespread exposure of the circulating blood to procoagulant activity.

Ultrasound --the use of sound waves having a frequency greater than 20,000 Hz to obtain images for medical diagnostic purposes.

Tracheotomy --incision into the trachea through the neck.

Tracheostomy --the opening created by a surgical cut into the trachea.

Swallow study --a procedure used to diagnose whether a patient aspirates contents while eating or drinking.

Decannulation --the removal of a tracheostomy tube from the trachea.

Postural Drainage & Vibration (PD&V) --bronchial hygiene therapy using vibration and body positioning to improve mobilization and clearance of bronchial secretions.