Chapter 74 Management of Thoracic Trauma
INTRODUCTION
The steps followed in the care of the traumatically injured patient are well described and outlined by the Advanced Trauma Life Support training put forth by the Committee on Trauma of the American College of Surgeons.1 Ensuring an airway and confirming effective breathing and circulation are prime goals and permit appropriate diagnosis and guide treatment options.
MANAGEMENT OF THORACIC TRAUMA STEPS
Incomplete Pleural Decompression of a Pneumothorax
• Consequence
• Prevention
Incomplete Decompression of a Hemothorax
• Consequence
• Repair
• Prevention
Unrecognized Aortic Tear
Patients suffering blunt injury of significant force are at elevated risk for aortic tear, most frequently seen just distal to the left subclavian orifice. Frequently, chest x-ray evidence suggests signs of great vessel injury including widened mediastinum, loss of the aortic knob, and pleural capping.2 Other signs that indicate heightened energy transfer include high rib fractures and sternal or scapular fractures.
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