Treatment of chest injuries
1964; Elsevier BV; Volume: 1; Issue: 1 Linguagem: Inglês
10.1016/s0011-3840(64)80012-5
ISSN1535-6337
Autores Tópico(s)Restraint-Related Deaths
ResumoThe two principal specific requirements in therapy of chest injuries are to enable the patient to breathe and to cough effectively. The therapeutic measures required range from such simple methods as intercostal nerve blocks, the application of sandbags to the chest wall and the humidification of inspired air, to endotracheal suction, tracheotomy and ventilation with a mechanical respirator. Shock from hemorrhage must be treated vigorously with whole blood. A hypotension which does not respond is often owing to respiratory acidosis from inadequate ventilation, a tension pneumothorax or cardiac tamponade. Once the ability of the patient to breathe and to cough has been restored, the main principle of therapy is expansion of the lung by the complete removal of air and fluid from the pleural cavity. This may be accomplished either with serial thoracenteses or with an intercostal tube. Thoracotomy is required in only a small percentage of chest injuries, usually for continued hemorrhage or for injury of the mediastinal or subdiaphragmatic viscera.
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