Initial Management and Resuscitation of Severe Chest Trauma - 07/04/12

Doi : 10.1016/j.emc.2011.10.010

Bruno Bernardin, MD ^a,^b,^c,^⁎ , Jean-Marc Troquet, MD ^c,^d
^a Department of Medicine, McGill University, Room A4.62, Royal Victoria Hospital, 687 Avenue Des Pins, Montreal, Quebec, H3A 1A1, Canada
^b Emergency Trauma Fellowship, Montreal General Hospital, McGill University Health Center, Room B2 117-3, 1650 Avenue Cedar, Montreal, Quebec, H3G 1A4, Canada
^c Emergency Department, Montreal General Hospital, McGill University Health Center, Room B2 117-3, 1650 Avenue Cedar, Montreal, Quebec, H3G 1A4, Canada
^d Department of Family Medicine, McGill University, 517 Avenue des Pins, Montreal, Quebec, H2S 1S4, Canada

Corresponding author. Emergency Department, Montreal General Hospital, McGill University Health Center, Room B2 117-3, 1650 Avenue Cedar, Montreal, Quebec, H3G 1A4, Canada.

Résumé

Severe chest trauma, blunt or penetrating, is responsible for up to 25% of traumatic deaths in North America. Respiratory compromise is the most frequent dramatic presentation in blunt trauma, while injuries to the heart and great vessels pose the greatest risk of immediate death following penetrating trauma. More than 80% of patients will be managed with interventions that can be performed in the emergency department. This article reviews the presentation, diagnosis, and management of the most important thoracic injuries. A structured approach to the acutely unstable patient is proposed to guide resuscitation decisions.

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Keywords : Thoracic trauma, Severe, Management, Unstable, Blunt, Penetrating