Anesthetic Implications for Management of Thoracic Trauma
Injury to the thoracic organs may be from blunt force or penetrating missiles and can result in obvious or subtle injuries. The leading causes of death from thoracic trauma are hypoxia and hypoventilation. The primary survey is a quick targeted examination to identify and treat, or to rule out life threatening injuries: tension pneumothorax, massive hemothorax, open pneumothorax, cardiac tamponade, flail chest, cardiac or aortic rupture.
Induction of anesthesia and institution of positive pressure ventilation can lead to rapid deterioration and catastrophic results in previously compensated patients who have suffered massive blood loss, or who have cardiac tamponade or tension pneumothorax.
In cases of severe injury to a unilateral hemithorax the need for lung isolation should be assessed.
KeywordsThoracic trauma Tension pneumothorax Blunt force trauma Cardiac tamponade Flail chest Venous air embolism
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