ABSTRACT
The modern city and the highway contribute more major trauma cases daily than do all the declared wars, undeclared wars and terrorist atrocities in the world. The burden of domestic trauma also has enormous implications for healthcare expenditure. In the USA approximately 60 million injuries are recorded annually, 30 million requiring professional care and 3.6 million being admitted to hospital and absorbing much of the health budget. Most importantly, 300 000 permanent disabilities are produced each year and trauma is responsible for more life-years lost than any other cause. Thoracic injuries occur at a rate of 12 per million of the population each day.1 Major chest trauma is present in 56 per cent of trauma fatalities2 and is directly responsible for a quarter of all deaths.3
