injuries poisoning
Overview of Thoracic Trauma
Symptoms and Signs of Thoracic Trauma
Symptoms include pain, which usually worsens with breathing if the chest wall is injured, and sometimes shortness of breath. Common findings include chest tenderness, ecchymoses, and respiratory distress; hypotension or shock may be present. Neck vein distention can occur in Pneumothorax (Tension) or Decreased breath sounds can result from pneumothorax or Hemothorax ; percussion over the affected areas is dull with hemothorax and hyperresonant with pneumothorax. The trachea can deviate away from the side of a tension pneumothorax. In Flail Chest , a segment of the chest wall moves paradoxically—that is, in the opposite direction from the rest of the chest wall (outward during expiration and inward during inspiration); the flail segment is often palpable. Subcutaneous emphysema causes a crackling or crunch when palpated. Findings may be localized to a small area or involve a large portion of the chest wall and/or extend to the neck. Most often, pneumothorax is the cause; when extensive, injury to the tracheobronchial tree or upper airway should be considered. Air in the mediastinum may produce a characteristic crunching sound synchronous with the heartbeat (Hamman sign or Hamman crunch). Hamman sign suggests Pneumomediastinum and often tracheobronchial tree injury or, rarely, esophageal injury. 