The management of chest injuries

ABSTRACT

In the over all management of chest injuries we may divide treatment into the first aid procedures and those that are definitive. First aid or early treatment procedures must be done immediately and they can be performed by the general practitioner. A good understanding of the anatomical relationships and cardiorespiratory physiology is of course necessary. Early treatment on first aid basis will include closure of an open pneumothorax or sucking wound, treatment of shock, correct respiratory obstruction, relief of tension penumothorax by thoracentesis, immobilization of a crushed chest, control of pain, and transfer of the patient to a hospital with adequate facilitiesDefinitive treatment requires the services of a competent surgeon and an adequate hospital. After a thorough evaluation of the case thoracotomy may be done to control intractable bleeding, to correct fractures or wounds of the traches or bronchus and esophagus, to explore thge thoraco-abdominal injuries, to correct cardiac tamponade and to perform cardiorrhaphy, and to repair vascular injuries such as false aneurysmMost chest injuries can be managed with conservative treatment. They respond fairly well when there is restoration of the normal physiology and anatomical relationship as early as possibleThe indications for highly surgical precedures are rather well dilineated and when it is determined that they are necessary they must be utilized without delay.(Summary)