Chest trauma requires a methodical and exact approach following general trauma principles. Signs of chest injury can be easily missed if other injuries are present. Thoracic trauma accounts for over 70% of traffic accident deaths. Blunt chest trauma alone has a 10% fatality rate, increasing to 30% with additional injuries. Emergency thoracotomy is indicated for massive hemothorax, suspected cardiac tamponade, or witnessed cardiac arrest in the resuscitation area, though success rates are low. The standard incision approach is a left anterior thoracotomy, extending to bilateral thoracotomies or clam-shell for right-sided penetrating injuries. Early deaths after thoracic trauma are often due to hypoxemia,

1. THE CHEST TRAUMA

2. APPROACH TO TRAUMA
• must be methodical and exact
• Signs of chest trauma in the presence of other
injury, may easily be missed.
• general principles of resuscitation and ATLS
(advanced trauma and life support) must be
followed.
• Thoracic trauma >70 per cent of all deaths,
following road traffic accidents.
• Blunt trauma to the chest in isolation is fatal in 10
per cent of cases, rising to 30 per cent if other
injuries are present.

3. INDICATIONS FOR EMERGENCY ROOM
THORACTOMY IN BLUNT CHEST TRAUMA
• massive haemothorax
• suspected cardiac tamponade
• witnessed cardiac arrest in the resuscitation
area.
• Success rates are low.

4. STANDARD APPROACH
• left anterior thoracotomy
• penetrating injury is in the right chest
– extend the incision to bilateral thoracotomies or a
clam-shell incision.

5. EARLY DEATHS AFTER
THORACIC TRAUMA
• caused by hypoxaemia, hypovolaemia and
tamponade.
• treating such patients
– diagnose and treat as early as possible
• The best approach is to remain highly
suspicious
• Early consultation is advised.
• essential that experienced help is summoned.