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Clinical Profile of Blunt Trauma Chest: A Hospital based Study

introduction: Blunt trauma to the chest is a very common occurrence in setting of traumatic incidents occurring with highest frequency in young adults between 15-35 years of age. Traumatic chest injuries lead to significant burden of mortality and morbidity in the young population. The most common modes of injury in such patients is motor vehicle accidents followed by other high energy traumatic scenarios like falls from height, contact sports, violence etc. This study was aimed at the evaluation and management of BCT with rib fractures and associated injuries. Material and Methods: The present study was a retrospective cum prospective hospital based study done in SKIMS Medical College Hospital, Srinagar, J & K, India. Sixty four patients who attended the Emergency Department with history of blunt chest injury were included in the study. Patients of all genders between 18 and 65 years of age were included in the study. The data regarding age, gender, mode of injury, presence of thoracic injuries, abdominal injuries, skeletal injuries was gathered and tabulated. Results: We observed a strong male preponderance with 45 out of 64 patients being male. Most common mode of injury was traffic accidents followed by falls from height, fall of heavy objects, hit by animals, violence and contact sports. Associated injuries were seen in both thoracic and extra-thoracic organs. Musculoskeletal injuries were also commonly seen. Patients were managed according to ATLS protocol; fifteen patients were managed with intercostal tube drainage four of which required thoracotomy, four patients required laparotomy for visceral injuries, four patients required fixation of vertebral fractures and musculoskeletal injuries were managed according to the orthopaedic protocols. In the present study four (6.25%) died as a result of massive thoracic injuries. Conclusion: Blunt chest injury is a serious injury which can result in life threatening complications which need to be anticipated, identified and adequately managed to reduce the rates of poor outcome. Integrated management employing the general surgeon, anesthetist, orthopaedician, internist and relevant paramedics is essential. Strict adherence to ATLS protocol is imperative. Adequate fluid resuscitation, ventilatory support, O2 inhalation, pulmonary physical therapy and efficient analgesia can lead to quick recovery and reduced rates of surgical intervention.