Therefore, a multidisciplinary approach is needed for these patients. Although trauma usually involves many tissues and organs, these life-threatening conditions show how important pulmonary injuries are in trauma patients.Ĭhest wall and pulmonary injuries caused by blunt thoracic trauma include many organs, tissues and systems. Similarly, 2 of these 6 conditions are pulmonary injuries due to trauma. The following potentially life-threatening injuries should be immediately investigated: pulmonary contusion, tracheobronchial injuries, diaphragmatic injuries, myocardial injury, thoracic aortic disruption, and esophageal injury. 13 Of note, 5 of the 6 most fatal causes indicate pulmonary and chest wall injuries in the trauma patient. In the primary survey of chest trauma patients, 6 life-threatening conditions (airway obstruction, tension pneumothorax, open pneumothorax, massive hemothorax, flail chest, pericardial tamponade) should be immediately investigated and treated. 10, 11 The mortality rate is hard to evaluate as the causes of death in blunt chest trauma may be due to pulmonary and nonpulmonary complications. 7, 8, 9 In addition, blunt chest trauma accounts for 15% of all trauma cases in the world. Considering that 70% of all chest traumas constitute blunt injuries, the importance of blunt injuries is understood. Falling from height, traffic accidents and occupational accidents are main mechanisms of blunt injuries. Blunt injuries can cause damage to organs and structures under the tissue without disrupting the integrity of the tissue. Penetrating injuries such as penetrating, cutting and firearm injuries are disruptive to tissue integrity. Trauma can be divided into two types: penetrating and blunt. Thoracic trauma occurs in approximately 60% of patients with polytrauma and has a mortality of 20%–25%. 3Ĭhest trauma remains a serious problem as high-speed vehicle accidents increase. 2 Although trauma-related injuries can occur in many parts of body, one out of four trauma patients die due to thoracic injury or its complications. 1 However, trauma is the most common cause of death in the age of first four decades.
Trauma is the third leading cause of death in all age groups after cardiovascular diseases and cancer. With definite diagnosis, the morbidity and mortality can be significantly reduced by simple treatment methods. Adequate pain control in chest trauma is sometimes the most basic and best treatment. This is because only 10% of thoracic trauma patients require surgical operation and the remaining 90% can be treated with simple methods such as appropriate airway, oxygen support, maneuvers, volume support and tube thoracostomy. For such patient, it is important to understand the treatment logic and to take a multidisciplinary approach to treat the pulmonary and chest wall injuries.
Following these injuries, patients may present with a simple dyspnea or even respiratory arrest. Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial injuries. As a result of chest trauma, many injuries may occur, such as pulmonary injuries, and these require urgent intervention. Blunt chest trauma is usually caused by motor vehicle accident, falling from height, blunt instrument injury and physical assault. This indicates the importance of chest trauma among all traumas. Blunt injuries constitute the majority of chest trauma. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Physical traumas are tragic and multifaceted injuries that suddenly threaten life.
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