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Chest Injury: The Indications for Artificial Ventilation

During the period April, 1968, to April, 1973, all patients admitted to Royal Newcastle Hospital with respiratory failure following chest injury were managed in the Acute Respiratory Unit. The great majority resulted from motor vehicle accidents. A total of 130 patients suffered respiratory failure following chest injury, and were all seen by at least one of us. Only 21 patients had isolated chest injury, 109 having multiple injuries. Twenty-four patients died, nine from associated cerebral contusion. The place of artificial ventilation in the proper management of chest injuries is discussed and particular stress is laid on those patients with conditions or injuries likely to lead to respiratory failure. In this category are those patients with significant flail segment, associated head or abdominal injury, the obese, and those with pre-existing chest disease.