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50 - Thoracic Trauma

from Section 11 - Trauma

Published online by Cambridge University Press:  02 November 2023

By
Lauren Becker
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Trauma to the thorax is often categorized as penetrating (i.e., gunshot wound, stab wound) or blunt (i.e., motor vehicle collision, fall). Bedside ultrasound is useful in the initial assessment of the patient with chest trauma to rapidly evaluate for pneumothorax and pericardial effusion as part of the extended focused assessment with sonography in trauma (eFAST).

  • Penetrating injuries to “the box” (the area defined by the clavicles superiorly, nipple lines laterally, and costal margins inferiorly) are of particular concern because of the high likelihood of injury to the heart and mediastinal structures. The diaphragm may elevate as high as the fourth intercostal space on exhalation, so concurrent abdominal injury must be considered when penetrating trauma is located at or below the fourth intercostal space.

Keywords

chest traumarib fracturepneumothoraxhemothoraxchest tubediaphragm injuryaortic injury
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 538 - 551
Publisher: Cambridge University Press
Print publication year: 2023

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References

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