Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

5 results

  • Cohort Study on the Prevalence and Risk Factors for Delayed Pulmonary Complications in Adults Following Minor Blunt Thoracic Trauma

  • Miville Plourde, Marcel Émond, André Lavoie, Chantal Guimont, Natalie Le Sage, Jean-Marc Chauny, Éric Bergeron, Laurent Vanier, Lynne Moore, Nadine Allain-Boulé, Ramona-Florina Fratu, Maryline Dufresne
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 16 / Issue 2 / March 2014
    Published online by Cambridge University Press:
    04 March 2015, pp. 136-143
    Print publication:
    March 2014
    • Article
      • You have access
    • PDF
    • Export citation
  • Objectives:

    The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma.

    Method:

    A prospective cohort of 450 consecutive patients was recruited. Eligible patients had to be over 16 years of age, consulted within 72 hours for a trauma, and available for outpatient follow-up at 2, 7, and 14 days posttrauma. The clinical outcome investigated was the presence of delayed pneumothorax or hemothorax on the follow-up chest x-ray.

    Outcomes:

    Delayed hemothorax occurred in 11.8% (95% CI 8.8–14.8), and delayed pneumothorax occurred in 0.9% (95% CI 0.2–2.3) of participants. During the 14-day follow-up period, 87.0% of these delayed complications developed in the first week. In the multivariate analysis, the only statistically significant risk factor for delayed complications was the location of fractures on the x-ray of the hemithorax. The adjusted odds ratio was 1.52 (95% CI 0.62–3.73) for the lower ribs (tenth to twelfth rib), 3.11 (95% CI 1.60–6.08) for the midline ribs (sixth to ninth rib), and 5.05 (95% CI 1.80–14.19) for the upper ribs (third to fifth rib) versus patients with no fractures.

    Conclusion:

    The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.

  • 21 - Tachyarrhythmias

  • from Section 4 - Cardiovascular emergencies
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 146-152

  • Summary

    This chapter discusses the diagnosis, evaluation and management of thoracic trauma including pneumothorax, hemothorax, cardiac tamponade, aortic injury, trachebronchial injury and flail chest. Tension pneumothorax presents with hypotension, tachypnea, tachycardia, distended neck veins, diminished or absent breath sounds on the affected side, and tracheal deviation away from the side of injury. Retained hemothorax following tube thoracostomy is a risk factor for infection, and should generally prompt early video assisted thoracic surgery (VATS). Traumatic pericardial tamponade must be treated with immediate surgical thoracotomy to address the cause of the bleeding into the pericardium. The critical patient with aortic injury who survives transport to the emergency department has a high probability of aortic rupture resulting in complete hemodynamic collapse and death if not immediately diagnosed and treated. Tracheal transection is associated with multiple other severe injuries. Endotracheal intubation and mechanical ventilation are indicated for the decompensating patient with flail chest.

  • Chapter 27 - Management of bronchopleural fistula

  • from Section 3 - Post-operative management
  • Edited by Cait P. Searl, Sameena T. Ahmed
  • Book:
    Core Topics in Thoracic Anesthesia
    Published online:
    10 December 2009
    Print publication:
    02 April 2009, pp 186-189

  • Summary

    Thoracic trauma accounts for 25% of all trauma related deaths. The majority of thoracic trauma patients can be managed conservatively by simple chest tube drainage, respiratory support and pain management. The mechanism of injury after thoracic trauma can be classified as blunt or penetrating trauma. The anesthetist plays an important role in the management of severe thoracic trauma from an initial stage of primary survey right through to management in the intensive care unit. In the emergency department, decisions and actions have to be taken without delay. In a trauma situation, there is little opportunity to obtain standard anesthetic pre-operative assessment. Video-assisted thoracic surgery is an important and extensively used diagnostic tool for suspected traumatic intrathoracic lesions, including stab wounds, in hemodynamically stable patients. Urgent thoracotomy is indicated in the presence of severe hemorrhage. A quick standard anesthetic assessment should be performed on all trauma patients.