The patient history (medical history) represents an important component in the diagnosis of thoracic trauma (chest injury). To assess the nature and extent of thoracic trauma, it is important to reconstruct how the accident occurred. If the victim is unresponsive, accident witnesses must be consulted. Current anamnesis/systemic anamnesis (somatic and psychological complaints). How did the … Chest Injury (Thoracic Trauma): Medical History
Respiratory System (J00-J99) Hematothorax (accumulation of blood in the pleural space (airless space between the pleura and pleura)). Hematopneumothorax (collapse of the lung characterized by air and blood accumulation). Unstable thorax Spontaneous tension pneumothorax – life-threatening form of pneumothorax in which increased pressure in the pleural space causes problems with blood flow to the heart … Chest Injury (Thoracic Trauma): Or something else? Differential Diagnosis
The following are the major conditions or complications that may be contributed to by chest trauma (thoracic injury): Respiratory system (J00-J99) Bronchial rupture (bronchial tear). Bronchotracheal injury – detachment or tearing of the trachea or bronchi. Chylothorax (accumulation of lymphatic fluid in the pleural space). Hematothorax (accumulation of blood in the pleural space). Hematopneumothorax – … Chest Injury (Thoracic Trauma): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps. Treatment of thoracic trauma (chest injury) must be rapid (immediate diagnosis). The entire body must always be searched to rule out concomitant injuries! In principle, an emergency examination according to the Glasgow Coma Scale (GCS) must first be performed on persons who are … Chest Injury (Thoracic Trauma): Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count [hemoglobin, hematocrit] Electrolytes – potassium, sodium Blood gas analysis (BGA) Determination of cardiac enzymes (aspartate aminotransferase (AST; GOT); CK-MB creatine kinase; hydroxybutyrate dehydrogenase (HBDH); lactate dehydrogenase (LDH); myoglobin; troponin T).
Mandatory medical device diagnostics. X-ray of the thorax (radiographic thorax/chest), in two planes. In only about 30% of cases are all injuries detected by radiography in blunt trauma. Occult (hidden) injuries are only revealed by computed tomography (CT). Common occult injuries include pulmonary contusions (pulmonary contusions), hematothoraces (accumulation of blood in the pleural space), sternal … Chest Injury (Thoracic Trauma): Diagnostic Tests
During emergency care, a decision may need to be made as to whether intubation (insertion of a tube (hollow probe) into the trachea/trachea) or a chest drain (drainage system used to drain fluids and/or air from the chest (thorax)) is necessary. Indications for intubation Respiratory insufficiency (respiratory failure; failure of external (mechanical) breathing). Unstable thorax … Chest Injury (Thoracic Trauma): Surgical Therapy
The following symptoms and complaints may indicate a chest trauma (thoracic injury): Pulmonary symptoms (affecting the lungs). Dyspnea (shortness of breath) Cough Tachypnea (respiratory rate > 20/min) Cardiac symptoms (affecting the heart) Hypotension (low blood pressure) Tachycardia (heartbeat too fast: > 100 beats per minute). Pain Retrosternal pain (pain behind the breastbone). Thoracic pain (pain … Chest Injury (Thoracic Trauma): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Thoracic trauma (chest injury) is differentiated by cause as follows: Blunt thoracic trauma (without bony involvement) – caused by impact or collision (e.g., traffic or work accidents; ski collision); approximately 90% of cases Thoracic contusion (Commotio thoraci) – without bony involvement. Thoracic contusion (contusio thoracis) – involvement of intrathoracic organs (organs … Chest Injury (Thoracic Trauma): Causes
General measures Immediately make an emergency call! (Call number 112) First aid or emergency measures (at the scene of the accident): Ensuring respiration Oxygen administration during spontaneous breathing: 8-10 liters/minute. Early intubation and pressure-controlled ventilation with 100% oxygen in case of insufficient spontaneous breathing (insufficient spontaneous breathing). Immediate relief if tension pneumothorax is suspected (life-threatening … Chest Injury (Thoracic Trauma): Therapy