Chest Trauma

Direct thoracic trauma leads to ¼ of all deaths from trauma. This stuff kills - Adam Thomas

Chest Trauma

image by: Elliot Hospital and Health System

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The Deadly Dozen of Thoracic Trauma

Injuries of the chest are common following both blunt and penetrating trauma. >85% of these injuries may be adequately managed via chest tube thoracostomy, aka. chest tube insertion...

The deadly dozen of trauma can be arbitrarily divided into the lethal 6 or those injuries that may kill your patient immediately and should be identified on the primary survey and the hidden 6 or those injuries that are “hidden” from the sense and require further adjunctive diagnostic tests in order to diagnose.

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 The Deadly Dozen of Thoracic Trauma

In this episode we review the "lethal 6" and "hidden 6" chest injuries that comprise the deadly dozen of thoracic trauma. Mechanism of injury together with vital signs and findings from the physical exam should provide us with the data needed to identify life-threatening thoracic injuries on our primary survey. For hidden injuries, the diagnostic adjuncts required to identify these injuries are also discussed.


The thoracic cavity contains three major anatomical systems: the airway, lungs, and the cardiovascular system. As such, any blunt or penetrating trauma can cause significant disruption to each of these systems that can quickly prove to be life threatening unless rapidly identified and treated. Chest trauma accounts for approximately 25% of mortality in trauma patients.

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