Initial management and resuscitation of severe chest trauma

Emerg Med Clin North Am. 2012 May;30(2):377-400, viii-ix. doi: 10.1016/j.emc.2011.10.010. Epub 2011 Dec 30.


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.

Publication types

  • Review

MeSH terms

  • Emergencies
  • Humans
  • Multiple Trauma / diagnosis
  • Multiple Trauma / therapy
  • Resuscitation*
  • Thoracic Injuries* / diagnosis
  • Thoracic Injuries* / etiology
  • Thoracic Injuries* / therapy
  • Wounds, Nonpenetrating* / complications
  • Wounds, Nonpenetrating* / diagnosis
  • Wounds, Nonpenetrating* / therapy
  • Wounds, Penetrating* / complications
  • Wounds, Penetrating* / diagnosis
  • Wounds, Penetrating* / therapy