Portable chest X-ray (CXR) is usually the first imaging test to be performed in major trauma patients, since it can detect life-threatening injuries such as tension pneumothorax, massive hemothorax, and malposition of tubes or lines ( 4). Despite borders among the clinical outcomes of different lesions are not always clearly defined, and some initially irrelevant lesions can turn into clinical severe conditions, we can divide traumatic thoracic lesions into three levels of priority and severity, and imaging tests should be used accordingly: life-threatening conditions, injuries associated to high energy trauma, and mild chest trauma. We should review traumatic thoracic injuries from a severity point of view. Conventional tests like chest radiographs and ultrasound, and computed tomography (CT) are the imaging techniques usually performed in the emergency setting ( 3). Patients with chest wall trauma are at significant risk for intrathoracic or intraabdominal injuries based upon their mechanism of injury or initial clinical assessment, thus, unless they require immediate surgery, these patients usually warrant further diagnostic imaging.Įither for life threatening conditions that require an emergent response, or for minor injuries, imaging is a key tool to guide many of the interventions and decisions in patients with chest trauma. Trauma is the fifth leading cause of death worldwide, and is the leading cause in people younger than 40 years old ( 2). Thoracic trauma is one of the most common locations of injury (after head and extremities), and has an overall mortality rate of up to 10% ( 1), so recognition of intrathoracic injuries must be a priority in chest trauma assessment. FAST, focused assessment in sonography for trauma. Video 2 An extended FAST examination that diagnoses the presence of rib fracture ( 36). In this article we review these techniques and their indications. Concise and early detection can be life-saving and determines the final results. After initial resuscitation, during the secondary surgery, chest computed tomography (CT) is the cornerstone test for assessing the presence of intrathoracic lesions secondary to penetrating or high-energy trauma, that can potentially threaten patient’s life. Chest X-ray and bedside ultrasound (focused assessment in sonography for trauma, FAST) are the initial tests for unstable patients, higher clinical suspicion or high-energy mechanism of accident. While primary care is carried out following the Advanced Trauma Life Support (ATLS) protocols, special attention must be taken to detect life-threatening conditions such as tension pneumothorax, pericardial tamponade or massive hemothorax, guided by clinical suspicion, assessment of the trauma mechanism and noninvasive imaging techniques available in situ or in the emergency department. Policy of Dealing with Allegations of Research MisconductĪbstract: Recognition of thoracic injuries during trauma assessment must be a priority due to the potential severity of intrathoracic or intrabdominal lesions.Policy of Screening for Plagiarism Process.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |