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Hemothorax, Emergency Medicine

Anthony C. Salazar Reviewed 06/2017



  • Accumulation of blood in the intrapleural space after blunt/penetrating chest trauma or other nontraumatic etiology. Bleeding is usually a result of disruption of the tissues/vessels...


Signs and Symptoms

  • Small amount of blood in thorax (<400 mL): Little or no change in patient's appearance, vital signs, or physical findings

  • Large amount of blood (>1,000 mL): Restlessne...



  • Assess vital signs and pulse oximetry; administer oxygen and obtain IV access.

  • Fluid resuscitation as needed for hypotension

  • Cautions:

    • Difficult to differentiate hemothoraces from p...



Admission Criteria

Patients with hemothoraces requiring tube thoracostomies should be admitted for monitoring and thoracostomy tube management to the trauma, cardiothoracic, or gen...

Pearls and Pitfalls

  • Because the pleural cavity of an average 70 kg man can hold over 4 L of blood, an exsanguinating hemorrhage can occur without any evidence of external blood loss.

  • Auscultation and p...

Additional Reading

  • Ali  HA, Lippmann  M, Mundathaje  U, et al. Spontaneous hemothorax: A comprehensive review. Chest.  2008;124(5):1056–1065.

  • McEwan  K, Thompson  P. Ultrasound to detect haemothor...



  • 511.89 Other specified forms of effusion, except tuberculous

  • 860.2 Traumatic hemothorax without mention of open wound into thorax

  • 860.3 Traumatic hemothorax with open wound into thorax

  • 860.4 Tr...

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