Ventilatory exchange should be assessed by looking at the chest and listening with a stethoscope. Airway patency does not assure adequate ventilation. The three traumatic conditions that most often compromise ventilation are tension pneumothorax, open pneumothorax, and a large flail chest with pulmonary contusion. Ventilation may be accomplished with an oral or nasal airway and a bag valve device. Chemical injuries may create life-threatening breathing problems.
Blast injuries can result in acute pulmonary dysfunction.
Adequate circulatory volume can be assessed by examining pulse, skin color, capillary refill, and blood pressure. If the radial pulse is palpable, the systolic pressure will be above 80mm of mercury. If the femoral or carotid pulse is palpable, the systolic pressure will be above 70mm of mercury. A quick and easy method of assessing the peripheral perfusion is the capillary blanch test, done on the hypothenar eminence, the thumb, or the toenail bed. In a normal volemic patient, the color returns to normal within two seconds.