Chest trauma

This article describes the life-threatening chest and mediastinal injuries seen in patients with blunt and penetrating trauma. It describes the clinical features of these injuries and their initial management, and also considers the imaging that can be used to confirm the diagnosis and plan ongoing management. The injuries discussed include tension pneumothorax, massive haemothorax, cardiac tamponade, flail chest and open pneumothorax. The presentation and management of other significant chest injuries, namely traumatic aortic dissection, pulmonary contusion and myocardial contusions, are also described. The article also suggests when cardiothoracic surgical consultation may be useful in the management of these patients.