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Chest Trauma, Penetrating, Emergency Medicine

Jean C.Y. Lo Reviewed 06/2017
 


Basics

Etiology

  • Gunshot wounds or stab wounds most common

  • Impalement on a sharp object from a fall can occur.

Diagnosis

Signs and Symptoms

  • Object impaled in the chest wall

  • Obvious wound in the chest wall with or without bleeding

  • Chest pain

  • Dyspnea

  • Respiratory distress

  • Altered mental status from hypoxemia

  • Absent or a...

Treatment

Pre-Hospital

  • Cautions:

    • All patients with signs of life in the field according to reports from EMS personnel should be transported to a trauma center.

    • Full spinal immobilization if spinal injury...

Follow-Up

Disposition

Admission Criteria

  • All patients with penetrating chest trauma should be admitted.

  • In penetrating torso trauma, resuscitative thoracotomy in the ED demonstrates survival when pre-hos...

Additional Reading

  • Ball  CG, Williams  BH, Wyrzykowski  AD, et al. A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. J Trauma.  2009;67:1123–1124.

  • ...

Codes

ICD9

  • 862.9 Injury to multiple and unspecified intrathoracic organs, with open wound into cavity

  • 875.0 Open wound of chest (wall), without mention of complication

  • 875.1 Open wound of chest (wall), c...

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