ABSTRACT
Haemothorax is accumulation of blood in the pleural cavity. Features are as for tension pneumothorax except percussion is dull rather than resonant. The pericardium fills with blood and restricts cardiac output. Cardiac tamponade can be easily confused clinically with tension pneumothorax. Causes of agitation in a trauma patient include hypoxia, hypovolaemia, hypoglycaemia, head injury, pain, intoxication, full bladder, tight dressings. The general principles of trauma management apply to any head injury: maintain oxygenation and cerebral perfusion by avoidance of hypoxia and hypotension. The aim of a burr hole is to prevent death by decompressing and partially evacuating a haematoma, e.g. an extradural haematoma due to laceration of the middle meningeal artery. A flail segment exists when two or more adjacent ribs fracture in two or more places, creating a segment of chest wall that moves paradoxically with respiration. Assessment of the pelvis for instability should only be performed once, as this may displace any blood clots that have formed.
