ABSTRACT
Thoracic trauma is uncommonly seen in isolation in children, and serves to indicate the magnitude of force and severity of injury; most children with chest injuries have high injury severity score overall with associated head, abdominal, and extremity injuries. Initial evaluation of the patient with suspected trauma includes activation of the appropriate resources (trauma response team). Pediatric patients have an even lower rate of survival after emergency department thoracotomy (EDT) than do adult patients, thought to be due to the higher proportion of blunt chest trauma mechanism. The most common injury after blunt trauma is pulmonary contusion, which can be seen in the absence of rib fracture or evidence of trauma on physical exam. The incidence of pneumothorax in children ranges from 5% to 38% of all chest injuries. Hemothorax is one of the more common thoracic injuries, with a reported incidence of 7%-29% of chest injuries in analyses of pediatric trauma registries.
