ABSTRACT
The nature of the incident and pattern of vehicle damage help in predicting the likely injuries. Early recognition is based on a rapid and systematic questioning and examination of the casualty. Throughout, the cervical spine must be protected until a vertebral injury has been excluded. This is achieved by manual in-line immobilization or triple immobilization with a cervical collar, head supports and strapping. Six immediately life-threatening injuries are recognized and managed during the primary survey, and eight potentially life-threatening injuries are sought during the secondary survey. Rupture is more common on the left, and rarely found in isolation, being associated with other chest, abdominal and pelvic injuries. Diaphragmatic ruptures associated with penetrating trauma result in a smaller tear. The primary goal in management of traumatic chest injuries is to rapidly identify and manage the six immediately life-threatening injuries within the primary survey.
