injuries poisoning
Overview of Thoracic Trauma
Pathophysiology of Thoracic Trauma
Most morbidity and mortality due to chest trauma occurs because injuries interfere with respiration, circulation, or both. Respirationcan be compromised by Direct damage to the lungs or airways Altered mechanics of breathing Injuries that directly damage the lung or airways include pulmonary contusion and tracheobronchial disruption. Injuries that alter the mechanics of breathing include Hemothorax , Circulationcan be impaired by Bleeding Decreased venous return Direct cardiac injury Bleeding, as occurs in hemothorax, can be massive, causing Shock (respiration is also impaired if hemothorax is large). Decreased venous return impairs cardiac filling, causing hypotension. Decreased venous return can occur due to increased intrathoracic pressure in tension pneumothorax or to increased intrapericardial pressure in Because chest wall injuries typically make breathing very painful, patients often limit inspiration (splinting). A common complication of splinting is Atelectasis , which can lead to hypoxemia, pneumonia, or both. Patients treated with tube Thoracotomy , particularly if a hemothorax is incompletely drained, may develop purulent intrathoracic infection (empyema). 