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Overview of Thoracic Trauma
Treatment of Thoracic Trauma
Supportive care Treatment of specific injuries Immediately life-threatening injuries are treated at the bedside at the time of diagnosis: Respiratory distress with suspected Pneumothorax (Tension) : Needle decompression Respiratory distress or shock with decreased breath sounds and suspected hemothorax: How To Do Tube and Catheter Thoracostomy Respiratory distress with suspected open pneumothorax: Partially occlusive dressing followed by tube thoracostomy Respiratory distress with suspected flail chest: Overview of Mechanical Ventilation None Shock with suspected Cardiac Tamponade : Pericardiocentesis Suspected hypovolemic shock: Intravenous Fluid Resuscitation None Immediate resuscitative thoracotomycan be considered for trauma victims if the clinician is proficient in the procedure and the patient has one of the following indications: Penetrating thoracic injury with a need for cardiopulmonary resuscitation (CPR) of<15 minutes Penetrating nonthoracic trauma with a need for CPR of<5 minutes Blunt trauma with a need for CPR of<10 minutes Persistent systolic blood pressure of<60 mm Hg due to suspected cardiac tamponade, hemorrhage, or air embolism In trauma patients with respiratory distress or shock and decreased breath sounds, tube thoracostomy can be done before imaging studies are obtained. In the absence of any of these criteria, resuscitative thoracotomy is contraindicated because the procedure has significant risks (eg, transmission of blood-borne diseases, injury to clinician) and costs. Specific treatment is directed at the injury. Supportive therapy typically includes analgesics, supplemental oxygen, and sometimes Overview of Mechanical Ventilation . 