Penetrating injuries to the chest

The principal problems in managing penetrating injuries to the chest are acute, life-threatening conditions (e.g. open pneumothorax, exsanguinating haemorrhage) and chronic conditions (e.g. clotted haemothorax leading to empyema or fibrothorax). Hypoxia and hypoventilation are the primary killers of patients with acute trauma. Life-threatening injuries must be identified and treated immediately. Injuries may develop later, and become life-threatening during resuscitation. Reassessment and evaluation is extremely important, particularly if the condition deteriorates. This contribution discusses the mechanism of injury, assessment, the primary survey and secondary survey, all essential components in the management of penetrating injuries to the chest.