Abstract
The multiple injured patient with thoracic trauma may pose a difficult challenge to the surgeon. Although the majority of chest injuries (85%) can be managed non-operatively, the presence of these injuries complicates the evaluation and treatment of concurrent extrathoracic trauma. The principles of Advanced Trauma Life Support (ATLS) published by the American College of Surgeons Committee on Trauma, combined with new insight into the concepts of deranged metabolism and physiologic exhaustion, can help one formulate a strategy for prioritizing diagnostic studies, optimizing resuscitative efforts, and conducting appropriate early definitive management. Our principal goal is to avoid prolonged shock by ensuring adequate oxygen delivery and circulating blood volume, and thereby, prevent secondary organ insults. Ideally, during these maneuvers, the physiologic stress response should be blunted with appropriate analgesics and/or sedation. Reduction and immobilization of skeletal trauma also serves to reduce physiologic stress and prevent complications. By outlining the goals of treatment for commonly encountered concomitant injuries, we hope to illustrate how these principles can be integrated for decision-making on the management of patients with serious thoracic trauma.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Selected References
Davella D, Bramilla G, Delfini R, et al: Guidelines fr the treatment f adults with severe head trauma (Part III). J Neursurg Sci 2000; 44:19–24.
Fischer PJ 2nd, Kent RB 3rd:Cmbined blunt thracic artic and abdminal trauma: diagnstic and treatment pririties. Suth Med Jurnal 2000; 93:865–867.
Hrtn TJ, Chn SM, Heidn P, et al: Identificatin f trauma patients at risk f thracic artic tear by mechanism f injury. J Trauma 2000; 48:1008–1014.
Kralvich K. A. & Obeid F. N. (1999). Abdminal Cmpartment Syndrme. In D.D. Trunkey & F.R. Lewis (Ed.), Current Therapy f Trauma, 4th Editin (pp. 360–363). St. Luis, Missuri: Msby, Inc.
Prcacci F, Stcchetti N, Citer G, et al: Guidelines fr the treatment f adults with severe head trauma (Part I). J Neursurg Sci 2000; 44:1–10.
Prcacci F, Stcchetti N, Citer G, et al: Guidelines fr the treatment f adults with severe head trauma Part II). J Neursurg Sci 2000; 44:11–18.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Science+Business Media New York
About this chapter
Cite this chapter
Obeid, F.N., Farber, M.S., Nguyen, D. (2002). Care of the Multiple Injured Patient with Thoracic Trauma. In: Karmy-Jones, R., Nathens, A., Stern, E.J. (eds) Thoracic Trauma and Critical Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1127-4_2
Download citation
DOI: https://doi.org/10.1007/978-1-4615-1127-4_2
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-5407-9
Online ISBN: 978-1-4615-1127-4
eBook Packages: Springer Book Archive