Lung Injuries in Combat

Abstract

This chapter is based on two universal truths in combat trauma: (1) You WILL be faced with severe thoracic injuries that require quick decisions and operative intervention, and (2) Most of you are not fellowship trained cardiothoracic surgeons and will not have one immediately available. You may be given the advice that “damage control in the chest is just like damage control in the abdomen” – don’t be lulled into complacency. Losing the comfort level and deep understanding of anatomic relationships that you have in the abdomen makes combat chest surgery an entirely different and often unforgiving adventure. There are two things you can do to set yourself up for success in thoracic trauma – Prepare and Practice. Prepare by reviewing any anatomy text or surgical atlas to get familiar with the critical structures and relationships as well as basic operative techniques. Practice by either scrubbing in to elective thoracic cases if you can, or by reviewing common thoracic injury scenarios and how you will handle them. Do not forget the most basic lesson of the soldier – “you will fight as you train.”