ABSTRACT
Chest trauma is the primary cause of death in about 25% of all trauma deaths and an associated factor in a further 50%, usually as a result of hypoxia and hypovolaemia. When the heart is not involved, the mortality of isolated penetrating chest trauma is <1%, but cardiac involvement increases mortality 20-fold. In an industrialized society, the commonest injury is to the chest wall, followed by pulmonary parenchymal injury, haemothorax, pneumothorax and flail chest. These conditions give rise to hypoxaemia and hypovolaemia, which are easily treatable with simple measures, consequently 85% of thoracic trauma victims can be successfully treated without the need for thoracic surgical intervention. Unfortunately, thoracic trauma is associated with other injuries, which may well account for the overall high mortality in these patients. This chapter will discuss the principles of management of thoracic trauma. Although the thoracic spine forms part of the thoracic cage, trauma to the spine is dealt with in Chapter 7.
