Deadly dozen: dealing with the 12 types of thoracic injuries.

Abstract

Although most thoracic trauma may be treated non-operatively, major thoracic trauma accounts for 25% of trauma deaths. Except for provision of a definitive airway and/or relief of a tension pneumothorax with a needle decompression, the vast majority of thoracic trauma is best served with "load and go," high-flow oxygen, placement of an IV line and administration of crystalloid solutions as the clinical scenario would indicate. Understanding the mechanism of injury is helpful in establishing both prehospital and in-hospital management priorities. Patients who sustain a single penetrating wound to the chest have the best survivability after a resuscitative thoracotomy. Practicing chest assessment skills is vital to being a good prehospital provider. Ultrasound, NIRS tissue oxygenation and telemedicine will likely become more commonly employed as prehospital monitoring options. PEEP, or "over bagging," may exacerbate a simple or open pneumothorax, converting it to a tension pneumothorax.

• Authors: Mark Cipolle, Michael Rhodes, Glen Tinkoff
• Journal: JEMS : a journal of emergency medical services (JEMS) Vol. 37 Issue 9 Pg. 60-5 (Sep 2012) ISSN: 0197-2510 [Print] United States
• PMID: 23342703 (Publication Type: Journal Article, Review)

Chemical References

• Crystalloid Solutions
• Isotonic Solutions
• Oxygen

Topics

• Crystalloid Solutions
• Diagnostic Imaging
• Emergency Medical Services (methods)
• Emergency Treatment
• Humans
• Infusions, Intravenous
• Isotonic Solutions (administration & dosage)
• Oxygen (administration & dosage)
• Telemedicine
• Thoracic Injuries (diagnosis, therapy)
• Thoracotomy