Penetrating thoracic trauma

A penetrating injury to the chest may be one of the more feared crises to face the surgical trainee. The patients are usually unstable, often uncooperative, and the solution is usually expedient surgery and one cannot procrastinate by requesting a CT scan. Rarely can the situation wait till a cardiothoracic surgeon arrives. In a major trauma centre, where the call from ambulance control will have drawn an experienced team to the resuscitation area, a well-rehearsed operative resuscitation will ensue, performed by surgeons whose main field of expertise may be emergency medicine, general surgery or even orthopaedic surgery. Due to the urgency of such cases, they may also present to any hospital with an A & E department, mandating that all doctors working in emergency care have a knowledge of penetrating injuries and the emergency surgery required to control their consequences. This article aims to help the surgical and emergency medicine trainee provide either definitive care or stabilization of the patient until specialist help arrives.