Traumatic Asphyxia occurs when a significant compressive force is applied to the thorax compressing the heart and lungs causing blood to back up and change flow direction in the right side of the heart and back up in to the superior vena cava and vessels of the upper extremities

 

 

 

Traumatic asphyxia causes desaturated venous blood to back up into the veins and capillaries of the head neck and upper extremities causing jugular vein distension and the skin to turn a deep red, purple or blue.The patients eyes may also be bulged out and face may be swollen.

 

 

The back flow of blood can have to potential to cause small hemorrhages, stagnant blood at the site of the compressive force and strokes in patients who are older which generally have less elastic veins which are more prone to rupture. If the compressive force continues for an extended period of time toxins and acids can build up much as in crush syndrome. The patient will also most likely have severe respiratory difficulty related to trauma inflicted by the the injury such as pneumothorax, hemothorax, and flail chest. The patient most likely will be hypovolemic, hypoxic and become hypotensive and may go into shock when the weight is removed

 

 

The treatment for traumatic asphyxia is similar to the treatment for crush syndrome.   Administer high flow oxygen to the patient. Usually a bag valve mask works best to provide positive pressure high flow oxygen to the patient.  Continue to support the airway as best as possible.  Start two Large bore IV's and prepare for rapid infusion once the compressive force is removed with crystaloid solution in anticipation of rapidly developing hypovolemia.  Also chest decompression may be needed for possible pneumo or hemothoraxes.  If the patient is entrapped for an extended period of time, 20 minutes or more, sodium bicarbonate may be administered, 1mEq/kg, to combat  the accumulation of toxins and metabolic acids.