n CME : Your SA Journal of CPD - The deadly dozen of chest trauma : main topic

Volume 22, Issue 7
  • ISSN : 0256-2170



A significant proportion of deaths from thoracic trauma occur virtually immediately (i.e. at the time of injury), for example rapid exsanguination following traumatic rupture of the aorta, or major vascular disruption after penetrating injury. <BR>Of survivors with thoracic injury who reach hospital, a significant proportion die in hospital as the result of mis-assessment or delay in the institution of treatment. These deaths occur early as a consequence of shock, or late as the result of ARDS and sepsis. <BR>Most life-threatening thoracic injuries can be simply and promptly treated after identification, by needle or tube placement for drainage. These are simple and effective techniques that can be performed by any medical practitioner. <BR>Emergency room thoracotomy (ERT) has distinct and specific indications. Indiscriminate use will not alter the morbidity or mortality, but will increase the risk of communicable disease transmission in health workers. <BR>Injuries to the chest wall and thoracic viscera can directly impair oxygen transport mechanisms. The hypoxia and hypoxaemia that results may cause secondary injury, especially to the brain. <BR>Brain injury can secondarily aggravate thoracic injuries by disrupting normal ventilatory patterns. In addition, the lung is a target organ for secondary injury following shock and remote injury.

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